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Radiother Oncol. 2014 Sep;112(3):371-5. doi: 10.1016/j.radonc.2014.07.012. Epub 2014 Aug 20.

An adaptive radiotherapy planning strategy for bladder cancer using deformation vector fields.

Author information

1
Department of Medical Physics, Aarhus University Hospital, Denmark. Electronic address: annveste@rm.dk.
2
Department of Clinical Experimental Oncology, Aarhus University Hospital, Denmark.
3
Department of Medical Physics, Aarhus University Hospital, Denmark.
4
Department of Oncology, Aarhus University Hospital, Denmark.

Abstract

PURPOSE:

Adaptive radiotherapy (ART) has considerable potential in treatment of bladder cancer due to large inter-fractional changes in shape and size of the target. The aim of this study was to compare our clinically applied method for plan library creation that involves manual bladder delineations (Clin-ART) with a method using the deformation vector fields (DVFs) resulting from intensity-based deformable image registrations (DVF-based ART).

MATERIALS AND METHODS:

The study included thirteen patients with urinary bladder cancer who had daily cone beam CTs (CBCTs) acquired for set-up. In both ART strategies investigated, three plan selection volumes were generated using the CBCTs from the first four fractions; in Clin-ART boolean combinations of delineated bladders were used, while the DVF-based strategy applied combinations of the mean and standard deviation of patient-specific DVFs. The volume ratios (VRs) of the course-averaged PTV for the two ART strategies relative the non-adaptive PTV were calculated.

RESULTS:

Both Clin-ART and DVF-based ART considerably reduced the course-averaged PTV, compared to non-adaptive RT. The VR for DVF-based ART was lower than for Clin-ART (0.65 vs. 0.73; p<0.01).

CONCLUSIONS:

DVF-based ART for bladder irradiation has a considerable normal tissue sparing potential surpassing our already highly conformal clinically applied ART strategy.

KEYWORDS:

ART; Adaptive; Bladder cancer; Deformation vector fields; Normal tissue sparing; Plan selection

PMID:
25150634
DOI:
10.1016/j.radonc.2014.07.012
[Indexed for MEDLINE]

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