PURPOSE: To evaluate the feasibility of adaptive radiotherapy (ART) in combination with a partial bladder irradiation. METHODS AND MATERIALS: Twenty-one patients with solitary T1-T4 N0M0 bladder cancer were treated to the bladder tumor + 2 cm margin planning target volume (PTV(CONV)). During the first treatment week, five daily computed tomography (CT) scans were made immediately before or after treatment. In the second week, a volume was constructed encompassing the gross tumor volumes (GTVs) on the planning scan and the five CT scans (GTV(ART)). The GTV(ART) was expanded with a 1 cm margin for the construction of a PTV(ART). Starting in the third week, patients were treated to PTV(ART). Repeat CT scans were used to evaluate treatment accuracy. RESULTS: On 5 of 91 repeat CT scans (5%), the GTV was not adequately covered by the PTV(ART). On treatment planning, there was only one scan in which the GTV was not adequately covered by the 95% isodose. On average, the treatment volumes were reduced by 40% when comparing PTV(ART) with PTV(CONV) (p < 0.0001). CONCLUSION: The adaptive strategy for bladder cancer is an effective way to deal with treatment errors caused by variations in bladder tumor position and leads to a substantial reduction in treatment volumes.
PURPOSE: To evaluate the feasibility of adaptive radiotherapy (ART) in combination with a partial bladder irradiation. METHODS AND MATERIALS: Twenty-one patients with solitary T1-T4 N0M0 bladder cancer were treated to the bladder tumor + 2 cm margin planning target volume (PTV(CONV)). During the first treatment week, five daily computed tomography (CT) scans were made immediately before or after treatment. In the second week, a volume was constructed encompassing the gross tumor volumes (GTVs) on the planning scan and the five CT scans (GTV(ART)). The GTV(ART) was expanded with a 1 cm margin for the construction of a PTV(ART). Starting in the third week, patients were treated to PTV(ART). Repeat CT scans were used to evaluate treatment accuracy. RESULTS: On 5 of 91 repeat CT scans (5%), the GTV was not adequately covered by the PTV(ART). On treatment planning, there was only one scan in which the GTV was not adequately covered by the 95% isodose. On average, the treatment volumes were reduced by 40% when comparing PTV(ART) with PTV(CONV) (p < 0.0001). CONCLUSION: The adaptive strategy for bladder cancer is an effective way to deal with treatment errors caused by variations in bladder tumor position and leads to a substantial reduction in treatment volumes.
Authors: Tanja Langsenlehner; Carmen Döller; Franz Quehenberger; Heidi Stranzl-Lawatsch; Uwe Langsenlehner; Karl Pummer; Karin S Kapp Journal: Strahlenther Onkol Date: 2010-03-26 Impact factor: 3.621
Authors: Jason A Efstathiou; Anthony L Zietman; Donald S Kaufman; Niall M Heney; John J Coen; William U Shipley Journal: World J Urol Date: 2006-11 Impact factor: 4.226
Authors: Dominique C van Rooijen; René Pool; Jeroen B van de Kamer; Maarten C C M Hulshof; Caro C E Koning; Arjan Bel Journal: Radiat Oncol Date: 2010-06-15 Impact factor: 3.481
Authors: Dominique C van Rooijen; Jeroen B van de Kamer; René Pool; Maarten C C M Hulshof; Caro C E Koning; Arjan Bel Journal: Radiat Oncol Date: 2009-09-24 Impact factor: 3.481