Transrectal implantation and stability of gold markers in prostate bed for salvage radiotherapy of macroscopic recurrences |
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| Institution: | 1. Department of Radiation Oncology, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495 Pierre-Benite, France;2. Department of Medical Physics, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495 Pierre Benite, France;3. Department of Urological Radiology, Hôpital Edouard Herriot, 5 Place d’Arsonval, 69003 Lyon, France;1. Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan;2. Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan;3. Department of Radiology, Kumamoto University Hospital, Kumamoto, Japan;4. Department of Civil and Environmental Engineering, Graduate School of Science and Technology, Kumamoto University, Japan;1. Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France;2. INSERM, CRCT, équipe n°15, Toulouse, France;3. Université Paul Sabatier, Toulouse, France;4. SCM Oncologie, Montauban, France;1. Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin;2. Departments of Radiation Oncology and Radiology, University of Washington, Seattle, Washington;3. Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas;4. Angell Animal Medical Center, Boston, Massachusetts;5. Division of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland;7. Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin;1. Veterans Affairs Medical Center and South Florida Veterans Affairs Foundation for Research and Education, Miami, FL;2. Department of Urology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL;3. Department of Pathology, Miller School of Medicine, University of Miami, Miami, FL;4. Division of Hematology/Oncology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL;5. Division of Endocrinology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL;6. Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL |
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| Abstract: | Background and purposeThe objective of the study was to verify the stability of gold markers in the prostatic bed (PB) during salvage radiotherapy.Material and methodsSeven patients, diagnosed with a macroscopic nodule visible on MRI, underwent targeted MRI-guided biopsies. Three gold markers were implanted into the PB close to the relapsing nodule for CT/MRI fusion. A dose of 60 Gy was delivered using IMRT to the PB followed by a dose escalation up to 72 Gy to the macroscopic nodule. Daily anterior and left-lateral kV-images were acquired for repositioning. The coordinates of the center of each marker were measured on the two kV-images. The distance variations (Dvar) of the markers in the first session and the subsequent ones were compared.ResultsNo marker was lost during treatment. The average distance between markers was 7.8 mm. The average Dvar was 0.8 mm, in absolute value. A total of 380/528 (72%) Dvar were ?1 mm. A Dvar greater than 2 mm was observed in 5.7% of measurements, with a maximum value of 4.8 mm.ConclusionsDespite the absence of the prostate, the implantation of gold markers in the PB remains feasible, with Dvar often less than 2 mm, and could be used to develop new approaches of salvage focal radiotherapy on the macroscopic relapse after prostatectomy. |
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| Keywords: | Local recurrence in prostate bed Gold markers stability Dose escalation IMRT-IGRT |
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