Assessment of dose to functional sub-structures in the lower urinary tract in locally advanced cervical cancer radiotherapy

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Assessment of dose to functional sub-structures in the lower urinary tract in locally advanced cervical cancer radiotherapy. / Spampinato, S.; Fokdal, L.; Marinovskij, E.; Axelsen, S.; Pedersen, E. M.; Pötter, R.; Lindegaard, J. C.; Tanderup, K.

I: Physica Medica, Bind 59, 2019, s. 127-132.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{c265c90deced460a81949b53b0c2d473,
title = "Assessment of dose to functional sub-structures in the lower urinary tract in locally advanced cervical cancer radiotherapy",
abstract = " Purpose: To provide an analysis of dose distribution in sub-structures that could be responsible for urinary toxicity after Image-Guided Adaptive BrachyTherapy (IGABT) in Locally Advanced Cervical Cancer (LACC). Methods: 105 LACC patients treated with radiochemotherapy and IGABT were selected. Sub-structures (bladder wall, trigone, bladder neck, urethra) were contoured on IGABT-planning MRIs. D 2cm3 and D 0.1cm3 , ICRU Bladder-Point (ICRU BP) and Posterior-Inferior Border of Symphysis points (PIBS, PIBS + 2 cm, PIBS − 2 cm) doses were extracted. Internal-Urethral-Ostium (IUO) and PIBS-Urethra (PIBS-U) points were defined as urethral dose surrogates. Finally, the Vaginal Reference Length (VRL) was extracted. Values were converted into total EBRT + BT equivalent dose in 2 Gy fractions using α/β = 3 and T 1/2 = 1.5 h. Results: Median D 2cm3 for bladder and trigone were 71.7[interquartile-range:66.5;74.1]Gy and 57.8[53.3;63.6]Gy, respectively, while median D 0.1cm3 were 82.2[77.6;89.1]Gy and 70.7[62.0;76.7]Gy, respectively. Median ICRU BP dose was 63.7[56.5;70.5]Gy and correlated with trigone D 2cm3 and D 0.1cm3 , while bladder and trigone D 2cm3 had poor correlation (R 2 = 0.492), as well as D 0.1cm3 (R 2 = 0.356). Bladder neck D 0.1cm3 was always lower than trigone D 0.1cm3 and higher than IUO. Correlation between PIBS + 2 cm and IUO was poor (R 2 = 0.273), while PIBS and PIBS-U were almost equal (R 2 = 0.990). VRL correlated with dose to bladder base. Conclusions: The study confirmed that ICRU BP and trigone doses correlate. Bladder D 2cm3 is not representative of trigone dose because hotspots are often placed in the bladder dome. VRL is a good indicator for bladder base sparing. In addition to D 2cm3 and D 0.1cm3 for whole bladder, ICRU BP, trigone D 2cm3 and D 0.1cm3 , IUO and PIBS are useful for lower urinary tract reporting. ",
keywords = "BLADDER, EXTERNAL-BEAM RADIOTHERAPY, GUIDED ADAPTIVE BRACHYTHERAPY, INTRACAVITARY BRACHYTHERAPY, MORBIDITY, PARAMETERS, POINT, PROSTATE-CANCER, RADIATION, RECTUM",
author = "S. Spampinato and L. Fokdal and E. Marinovskij and S. Axelsen and Pedersen, {E. M.} and R. P{\"o}tter and Lindegaard, {J. C.} and K. Tanderup",
year = "2019",
doi = "10.1016/j.ejmp.2019.01.017",
language = "English",
volume = "59",
pages = "127--132",
journal = "Physica Medica",
issn = "1120-1797",
publisher = "Elsevier Ltd",

}

RIS

TY - JOUR

T1 - Assessment of dose to functional sub-structures in the lower urinary tract in locally advanced cervical cancer radiotherapy

AU - Spampinato, S.

AU - Fokdal, L.

AU - Marinovskij, E.

AU - Axelsen, S.

AU - Pedersen, E. M.

AU - Pötter, R.

AU - Lindegaard, J. C.

AU - Tanderup, K.

PY - 2019

Y1 - 2019

N2 - Purpose: To provide an analysis of dose distribution in sub-structures that could be responsible for urinary toxicity after Image-Guided Adaptive BrachyTherapy (IGABT) in Locally Advanced Cervical Cancer (LACC). Methods: 105 LACC patients treated with radiochemotherapy and IGABT were selected. Sub-structures (bladder wall, trigone, bladder neck, urethra) were contoured on IGABT-planning MRIs. D 2cm3 and D 0.1cm3 , ICRU Bladder-Point (ICRU BP) and Posterior-Inferior Border of Symphysis points (PIBS, PIBS + 2 cm, PIBS − 2 cm) doses were extracted. Internal-Urethral-Ostium (IUO) and PIBS-Urethra (PIBS-U) points were defined as urethral dose surrogates. Finally, the Vaginal Reference Length (VRL) was extracted. Values were converted into total EBRT + BT equivalent dose in 2 Gy fractions using α/β = 3 and T 1/2 = 1.5 h. Results: Median D 2cm3 for bladder and trigone were 71.7[interquartile-range:66.5;74.1]Gy and 57.8[53.3;63.6]Gy, respectively, while median D 0.1cm3 were 82.2[77.6;89.1]Gy and 70.7[62.0;76.7]Gy, respectively. Median ICRU BP dose was 63.7[56.5;70.5]Gy and correlated with trigone D 2cm3 and D 0.1cm3 , while bladder and trigone D 2cm3 had poor correlation (R 2 = 0.492), as well as D 0.1cm3 (R 2 = 0.356). Bladder neck D 0.1cm3 was always lower than trigone D 0.1cm3 and higher than IUO. Correlation between PIBS + 2 cm and IUO was poor (R 2 = 0.273), while PIBS and PIBS-U were almost equal (R 2 = 0.990). VRL correlated with dose to bladder base. Conclusions: The study confirmed that ICRU BP and trigone doses correlate. Bladder D 2cm3 is not representative of trigone dose because hotspots are often placed in the bladder dome. VRL is a good indicator for bladder base sparing. In addition to D 2cm3 and D 0.1cm3 for whole bladder, ICRU BP, trigone D 2cm3 and D 0.1cm3 , IUO and PIBS are useful for lower urinary tract reporting.

AB - Purpose: To provide an analysis of dose distribution in sub-structures that could be responsible for urinary toxicity after Image-Guided Adaptive BrachyTherapy (IGABT) in Locally Advanced Cervical Cancer (LACC). Methods: 105 LACC patients treated with radiochemotherapy and IGABT were selected. Sub-structures (bladder wall, trigone, bladder neck, urethra) were contoured on IGABT-planning MRIs. D 2cm3 and D 0.1cm3 , ICRU Bladder-Point (ICRU BP) and Posterior-Inferior Border of Symphysis points (PIBS, PIBS + 2 cm, PIBS − 2 cm) doses were extracted. Internal-Urethral-Ostium (IUO) and PIBS-Urethra (PIBS-U) points were defined as urethral dose surrogates. Finally, the Vaginal Reference Length (VRL) was extracted. Values were converted into total EBRT + BT equivalent dose in 2 Gy fractions using α/β = 3 and T 1/2 = 1.5 h. Results: Median D 2cm3 for bladder and trigone were 71.7[interquartile-range:66.5;74.1]Gy and 57.8[53.3;63.6]Gy, respectively, while median D 0.1cm3 were 82.2[77.6;89.1]Gy and 70.7[62.0;76.7]Gy, respectively. Median ICRU BP dose was 63.7[56.5;70.5]Gy and correlated with trigone D 2cm3 and D 0.1cm3 , while bladder and trigone D 2cm3 had poor correlation (R 2 = 0.492), as well as D 0.1cm3 (R 2 = 0.356). Bladder neck D 0.1cm3 was always lower than trigone D 0.1cm3 and higher than IUO. Correlation between PIBS + 2 cm and IUO was poor (R 2 = 0.273), while PIBS and PIBS-U were almost equal (R 2 = 0.990). VRL correlated with dose to bladder base. Conclusions: The study confirmed that ICRU BP and trigone doses correlate. Bladder D 2cm3 is not representative of trigone dose because hotspots are often placed in the bladder dome. VRL is a good indicator for bladder base sparing. In addition to D 2cm3 and D 0.1cm3 for whole bladder, ICRU BP, trigone D 2cm3 and D 0.1cm3 , IUO and PIBS are useful for lower urinary tract reporting.

KW - BLADDER

KW - EXTERNAL-BEAM RADIOTHERAPY

KW - GUIDED ADAPTIVE BRACHYTHERAPY

KW - INTRACAVITARY BRACHYTHERAPY

KW - MORBIDITY

KW - PARAMETERS

KW - POINT

KW - PROSTATE-CANCER

KW - RADIATION

KW - RECTUM

UR - http://www.scopus.com/inward/record.url?scp=85061364018&partnerID=8YFLogxK

U2 - 10.1016/j.ejmp.2019.01.017

DO - 10.1016/j.ejmp.2019.01.017

M3 - Journal article

C2 - 30772142

AN - SCOPUS:85061364018

VL - 59

SP - 127

EP - 132

JO - Physica Medica

JF - Physica Medica

SN - 1120-1797

ER -