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Title: Proximal seminal vesicle displacement and margins for prostate cancer radiotherapy.
Austin Authors: Lim Joon, Daryl ;Chao, Michael ;Piccolo, Angelina;Schneider, Michal;Anderson, Nigel;Handley, Monica;Benci, Margaret;Ong, Wee Loon ;Daly, Karen;Morrell, Rebecca;Wan, Kenneth;Lawrentschuk, Nathan;Foroudi, Farshad ;Jenkins, Trish ;Angus, David ;Wada, Morikatsu ;Sengupta, Shomik ;Khoo, Vincent
Affiliation: Olivia Newton-John Cancer Wellness and Research Centre
Monash University, Melbourne, Vic., Australia
Radiation Oncology
Royal Marsden NHS Foundation Trust, London, UK
Issue Date: 12-Jan-2021 2021
Publication information: Journal of Medical Radiation Sciences 2021; online first: 12 January
Abstract: Guidelines recommend that the proximal seminal vesicles (PrSV) should be included in the clinical target volume for locally advanced prostate cancer patients undergoing radiotherapy. Verification and margins for the prostate may not necessarily account for PrSV displacement. The purpose was to determine the inter-fraction displacement of the PrSV relative to the prostate during radiotherapy. Fiducials were inserted into the prostate, and right and left PrSV (RSV and LSV) in 30 prostate cancer patients. Correctional shifts for the prostate, right and left PrSV and pelvic bones were determined from each patient's 39 daily orthogonal portal images relative to reference digitally reconstructed radiographs. There was a significant displacement of the RSV relative to the prostate in all directions: on average 0.38 mm (95% confidence interval (CI) 0.26 to 0.50) to the left, 0.80-0.81 mm (CI 0.68 to 0.93) superiorly and 1.51 mm (CI 1.36 to 1.65) posteriorly. The LSV was significantly displaced superiorly to the prostate 1.09-1.13 mm (CI 0.97 to 1.25) and posteriorly 1.81 mm (CI 1.67 to 1.96), but not laterally (mean 0.06, CI -0.06 to 0.18). The calculated PTV margins (left-right, superior-inferior, posterior-anterior) were 4.9, 5.3-5.6 and 4.8 mm for the prostate, 5.2, 7.1-8.0 and 9.7 mm for the RSV, and 7.2, 7.5-7.6 and 8.6 mm for the LSV. There is a significant displacement of the PrSV relative to the prostate during radiotherapy. Greater margins are recommended for the PrSV compared to the prostate.
DOI: 10.1002/jmrs.457
ORCID: 0000-0002-1947-9694
PubMed URL: 33432719
Type: Journal Article
Subjects: Clinical target volume
fiducial markers
planning target volume
prostate cancer
radiotherapy planning
seminal vesicles
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