Evaluation of interfractional organ motion during neoadjuvant radiotherapy for rectal cancer patients.


Ergen Ş. A., Demir E., Can G., Karacam S., Barlas C., Oksuz D.

Bratislavske lekarske listy, cilt.124, sa.4, ss.280-284, 2023 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 124 Sayı: 4
  • Basım Tarihi: 2023
  • Doi Numarası: 10.4149/bll_2023_043
  • Dergi Adı: Bratislavske lekarske listy
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE
  • Sayfa Sayıları: ss.280-284
  • Anahtar Kelimeler: cone-beam computed tomography, interfractional organ motion, mesorectum, neoadjuvant radiotherapy, rectal cancer
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

OBJECTIVE: To investigate interfractional motion of the mesorectum and bladder and to assess dosimetric changes using cone-beam computed tomography (CBCT) during neoadjuvant radiotherapy for locally advanced rectal cancer patients. METHODS: Twenty-one patients who underwent volumetric arc therapy with CBCT imaging protocol were retrieved. The mesorectum and bladder were delineated on every CBCT image, and treatment plans were recalculated for all CBCTs. The organ motion was analyzed as a mean shift on the X-Y-Z axes. The volume changes were evaluated using the DICE index. Mann–Whitney U test was used in pairwise comparison analysis and ANOVA was used to compare shifts in each direction. RESULTS: A total of 105 CBCTs were evaluated retrospectively. The movement of the total mesorectum was found to be 1.5 mm, 4 mm, and 5 mm on the X-Y-Z-axes, respectively. In the subgroup analysis, the movement of the 1/3 upper mesorectum on the Y-axis was signifi cantly higher (mean movement 8 mm, p = 0.005). Mean bladder displacements were 2 mm, 4 mm, and 8 mm on the X-Y-Z-axes, respectively. In the D2, D95, and D98 doses, there was no statistically signifi cant change depending on the motion. CONCLUSION: During radiotherapy planning, the mesorectal movement should not be forgotten and PTV margins should be determined accordingly (Tab. 6, Ref. 22). Text in PDF www.elis.sk