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Title: Towards individualised radiotherapy for Stage I seminoma.
Austin Authors: Martin, Jarad M;Joon, Daryl Lim;Ng, Nicole;Grace, Michael;Gelderen, David Van;Lawlor, Marita ;Wada, Morikatsu ;Joon, Michael Lim;Quong, George;Khoo, Vincent
Affiliation: Radiation Oncology
Issue Date: 1-Sep-2005
Publication information: Radiotherapy and Oncology : Journal of the European Society For Therapeutic Radiology and Oncology; 76(3): 251-6
Abstract: Adjuvant radiotherapy is currently standard treatment of Stage I seminoma (SOS). The use of computerised tomogram (CT) planning is compared with traditional planning for greater treatment individualisation.Two plans were generated for each of 10 patients: one using traditional rectangular para-aortic fields, and one using conformal fields. The primary target volume compared was the dosimetric coverage of the inferior vena cava and aorta.The dosimetric analysis of traditional plans showed that they provided reasonable dosimetric coverage of the CTV. However, if 1cm is used for uncertainty based on nodal coverage then the periphery of the PTV could be significantly under-dosed. The CT based plan delivered improved dosimetry to the vessel PTV compared with the traditional field (CT D 95=24.7 Gy, traditional D 95=23.6 Gy, P=0.002). CT-based plans were significantly wider than traditional plans (CT=11.8 cm, traditional=9 cm, P=0.002). The CT plan tended to irradiate relatively small volumes of the kidneys to higher doses.Traditional para-aortic fields may deliver suboptimal dosimetry to an anatomically defined PTV. Our CT-based fields tend to be wider than traditional fields, and provide improved dosimetry to vessels based target volumes. Given that traditional fields are often delivering significantly less than the prescribed dose to the target volume, and that marginal relapses cause a high proportion of treatment failure, there is a suggestion that CT-based plans may avoid under-dosage and geographical miss sometimes seen with traditional plans.
DOI: 10.1016/j.radonc.2005.08.005
Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Type: Journal Article
Subjects: Dose Fractionation
Radiotherapy, Adjuvant
Radiotherapy, Conformal.methods
Retrospective Studies
Tomography, X-Ray Computed
Appears in Collections:Journal articles

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