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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Justification for inter-fraction correction of catheter movement in fractionated high dose-rate brachytherapy treatment of prostate cancer.
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Justification for inter-fraction correction of catheter movement in fractionated high dose-rate brachytherapy treatment of prostate cancer.

机译：分次高剂量率近距离放射治疗前列腺癌中导管移动的部分间校正的理由。

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BACKGROUND AND PURPOSE: Fractionated high dose-rate (HDR) brachytherapy in the treatment of prostate cancer relies on reproducible catheter positions for each fraction to ensure adequate tumour coverage while minimising dose to normal tissues. Peri-prostatic oedema may cause caudal displacement of the catheters relative to the prostate gland between fractions. This can be corrected for by changing source dwell positions or by physical re-advancement of catheters before treatment. MATERIALS AND METHODS: Data for 20 consecutive monotherapy patients receiving three HDR fractions of 10.5 Gy per fraction over 2 days were analysed retrospectively. Pre-treatment CT scans were used to assess the effect of catheter movement between fractions on implant quality, with and without movement correction. Implant quality was evaluated using dosimetric parameters. RESULTS: Compared to the first fraction (f1) the mean inter-fraction caudal movement relative to the prostate base was 7.9 mm (f2) (range 0-21 mm) and 3.9 mm (f3) (range 0-25.5 mm). PTV D90% was reduced without movement correction by a mean of 27.8% (f2) and 32.3% (f3), compared with 5.3% and 5.1%, respectively, with catheter movement correction. Dose to 2 cc of the rectum increased by a mean of 0.69 (f2) and 0.76 Gy (f3) compared with an increase of 0.03 and 0.04 Gy, respectively, with correction. The urethra V12 also increased by a mean of 0.36 (f2) and 0.39 Gy (f3) compared with 0.06 and 0.16 Gy, respectively, with correction. CONCLUSIONS: Inter-fraction correction for catheter movement using pre-treatment imaging is critical to maintain the quality of an implant. Without movement correction there is significant risk of tumour under-dosage and normal tissue over-dosage. The findings of this study justify additional imaging between fractions in order to carry out correction.
机译：背景与目的：分级高剂量率（HDR）近距离放射疗法在治疗前列腺癌中依赖于每个部分的可重现导管位置，以确保足够的肿瘤覆盖范围，同时将对正常组织的剂量降至最低。前列腺周围水肿可能会导致各部分之间导管相对于前列腺的尾部移位。可以通过更改源停留位置或在治疗前通过导管的物理前移来对此进行纠正。材料与方法：回顾性分析了连续2天内接受3个HDR分数为10.5 Gy /分数的HDR分数的连续20例单药治疗患者的数据。使用治疗前CT扫描评估有无移动校正的情况下，各部分之间导管移动对植入物质量的影响。使用剂量参数评估植入物质量。结果：与第一部分（f1）相比，相对于前列腺基底的平均部分间c尾运动为7.9 mm（f2）（范围为0-21 mm）和3.9 mm（f3）（范围为0-25.5 mm）。在不进行运动校正的情况下，PTV D90％分别降低了27.8％（f2）和32.3％（f3），相比之下，经导管运动校正的PTV D90％分别降低了5.3％和5.1％。校正后，至2 cc直肠的剂量平均增加0.69（f2）和0.76 Gy（f3），而分别增加0.03和0.04 Gy。校正后，尿道V12的平均值分别为0.06和0.16 Gy，分别增加了0.36（f2）和0.39 Gy（f3）。结论：采用预处理成像技术对导管运动进行小段间矫正对于维持植入物的质量至关重要。如果不进行运动校正，则存在肿瘤剂量不足和正常组织剂量过多的显着风险。这项研究的发现证明了在馏分之间进行额外的成像以进行校正。

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