TY - JOUR
T1 - A study to quantify the effectiveness of daily endorectal balloon for prostate intrafraction motion management
AU - Wang, Ken Kang Hsin
AU - Vapiwala, Neha
AU - Deville, Curtiland
AU - Plastaras, John P.
AU - Scheuermann, Ryan
AU - Lin, Haibo
AU - Bar Ad, Voika
AU - Tochner, Zelig
AU - Both, Stefan
PY - 2012/7/1
Y1 - 2012/7/1
N2 - Purpose: To quantify intrafraction prostate motion between patient groups treated with and without daily endorectal balloon (ERB) employed during prostate radiotherapy and establish the effectiveness of the ERB. Methods: Real-time intrafraction prostate motion from 29 non-ERB (1,061 sessions) and 30 ERB (1,008 sessions) patients was evaluated based on three-dimensional (3D), left, right, cranial, caudal, anterior, and posterior displacements. The average percentage of time with 3D and unidirectional prostate displacements >2, 3, 4, 5, 6, 7, 8, 9, and 10 mm in 1-min intervals was calculated for up to 6 min of treatment time. The Kolmogorov-Smirnov method was used to evaluate the intrafraction prostate motion pattern between both groups. Results: Large 3D motion (up to 1 cm or more) was only observed in the non-ERB group. The motion increased as a function of elapsed time for displacements >2-8 mm for the non-ERB group and >2-4 mm for the ERB group (p < 0.05). The percentage time distributions between the two groups were significantly different for motion >5 mm (p < 0.05). The 3D symmetrical internal margin (IM) can be reduced from 5 to 3 mm (40% reduction), whereas the asymmetrical IM can be reduced from 3 to 2 mm (33% reduction) in cranial, caudal, anterior, and posterior for 6 min of treatment, when ERB is used. Beyond 6 min, the symmetrical 3D and asymmetrical cranial, caudal, anterior, and posterior IMs can be reduced from 9, 4, 7, 7, and 8 to 5, 2, 5, 3, and 4 mm, respectively (up to 57% reduction). Conclusion: The percentage of time that the prostate was displaced in any direction was less in the ERB group for almost all magnitudes of motion considered. The directional analysis shows that the ERB reduced IMs in almost all directions, especially the anterior-posterior direction.
AB - Purpose: To quantify intrafraction prostate motion between patient groups treated with and without daily endorectal balloon (ERB) employed during prostate radiotherapy and establish the effectiveness of the ERB. Methods: Real-time intrafraction prostate motion from 29 non-ERB (1,061 sessions) and 30 ERB (1,008 sessions) patients was evaluated based on three-dimensional (3D), left, right, cranial, caudal, anterior, and posterior displacements. The average percentage of time with 3D and unidirectional prostate displacements >2, 3, 4, 5, 6, 7, 8, 9, and 10 mm in 1-min intervals was calculated for up to 6 min of treatment time. The Kolmogorov-Smirnov method was used to evaluate the intrafraction prostate motion pattern between both groups. Results: Large 3D motion (up to 1 cm or more) was only observed in the non-ERB group. The motion increased as a function of elapsed time for displacements >2-8 mm for the non-ERB group and >2-4 mm for the ERB group (p < 0.05). The percentage time distributions between the two groups were significantly different for motion >5 mm (p < 0.05). The 3D symmetrical internal margin (IM) can be reduced from 5 to 3 mm (40% reduction), whereas the asymmetrical IM can be reduced from 3 to 2 mm (33% reduction) in cranial, caudal, anterior, and posterior for 6 min of treatment, when ERB is used. Beyond 6 min, the symmetrical 3D and asymmetrical cranial, caudal, anterior, and posterior IMs can be reduced from 9, 4, 7, 7, and 8 to 5, 2, 5, 3, and 4 mm, respectively (up to 57% reduction). Conclusion: The percentage of time that the prostate was displaced in any direction was less in the ERB group for almost all magnitudes of motion considered. The directional analysis shows that the ERB reduced IMs in almost all directions, especially the anterior-posterior direction.
KW - Calypso
KW - Endorectal balloon
KW - Intrafraction motion
KW - Prostate
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U2 - 10.1016/j.ijrobp.2011.07.038
DO - 10.1016/j.ijrobp.2011.07.038
M3 - Article
C2 - 22115790
AN - SCOPUS:84861599685
SN - 0360-3016
VL - 83
SP - 1055
EP - 1063
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 3
ER -