Stereotactic Body Radiation Therapy for Prostate

Stereotactic body radiation therapy treatment planning and delivery were conducted as previously described (25 (link), 26 (link)). Briefly, gold fiducials were placed into the prostate. Fused CT and MR images were used for treatment planning. The clinical target volume (CTV) included the prostate and the proximal seminal vesicles. The planning target volume (PTV) equaled the CTV expanded 3 mm posteriorly and 5 mm in all other dimensions. The prescription dose was 35–36.25 Gy to the PTV delivered in five fractions of 7–7.25 Gy over 1–2 weeks (27 (link)). The prescription isodose line was limited to ≥75%. The bladder and membranous urethra were contoured and evaluated with dose–volume histogram analysis during treatment planning using Multiplan (Accuray Inc., Sunnyvale, CA, USA) inverse treatment planning. Critical structure dose constraints were as previously described (26 (link)). To minimize the risk of local recurrence, no attempt was made to limit the dose to the prostatic urethra. Target position was verified during treatment using paired, orthogonal X-ray images (25 (link), 28 (link)).

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Woo J.A., Chen L.N., Bhagat A., Oermann E.K., Kim J.S., Moures R., Yung T., Lei S., Collins B.T., Kumar D., Suy S., Dritschilo A., Lynch J.H, & Collins S.P. (2014). Clinical Characteristics and Management of Late Urinary Symptom Flare Following Stereotactic Body Radiation Therapy for Prostate Cancer. Frontiers in Oncology, 4, 122.

Publication 2014

Multiplan

Bladder Body Delivery Gold Membranous Prostatic Recurrence Seminal vesicles Stereotactic radiation therapy Urethra

Corresponding Organization :

Other organizations : Georgetown University, University of the District of Columbia

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Variable analysis

independent variables

Stereotactic body radiation therapy treatment planning and delivery

dependent variables

Local recurrence risk
Bladder and membranous urethra dose-volume histogram analysis

control variables

Placement of gold fiducials into the prostate
Fused CT and MR images used for treatment planning
Clinical target volume (CTV) included the prostate and the proximal seminal vesicles
Planning target volume (PTV) equaled the CTV expanded 3 mm posteriorly and 5 mm in all other dimensions
Prescription dose of 35–36.25 Gy to the PTV delivered in five fractions of 7–7.25 Gy over 1–2 weeks
Prescription isodose line limited to ≥75%
Bladder and membranous urethra contoured and evaluated with dose–volume histogram analysis during treatment planning using Multiplan (Accuray Inc., Sunnyvale, CA, USA) inverse treatment planning
Critical structure dose constraints as previously described
No attempt to limit the dose to the prostatic urethra
Target position verified during treatment using paired, orthogonal X-ray images

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