Characterization of an Iodinated Rectal Spacer for Prostate Photon and Proton Radiation Therapy

被引：10

作者：

Kamran, Sophia C. ^{[1
]}

McClatchy, David M. ^{[1
]}

Pursley, Jennifer ^{[1
]}

V. Trofimov, Alexei ^{[1
]}

Remillard, Kyla ^{[1
]}

Saraf, Anurag ^{[1
,2
]}

Ghosh, Anushka ^{[1
]}

Thabet, Ashraf ^{[3
]}

Sutphin, Patrick ^{[3
]}

Miyamoto, David T. ^{[1
]}

Efstathiou, Jason A. ^{[1
]}

机构：

[1] Harvard Med Sch, Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02115 USA

[2] Harvard Med Sch, Massachusetts Gen Hosp, Harvard Radiat Oncol Program, Boston, MA 02115 USA

[3] Harvard Med Sch, Massachusetts Gen Hosp, Dept Intervent Radiol, Boston, MA 02115 USA

来源：

PRACTICAL RADIATION ONCOLOGY | 2022年 / 12卷 / 02期

关键词：

DOSE-RATE BRACHYTHERAPY; HYDROGEL; RADIOTHERAPY; OUTCOMES; TRIAL; RISK;

D O I：

10.1016/j.prro.2021.09.009

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Conventional rectal spacers (nonI-SPs) are low-contrast on computed tomography (CT), often necessitating magnetic resonance imaging for accurate delineation. A new formulation of spacers (I-SPs) incorporates iodine to improve radiopacity and CT visualization. We characterized placement, stability, and plan quality of I-SPs compared to nonI-SPs. Methods and Materials: Patients with intact prostate cancer (n = 50) treated with I-SPs and photons were compared to randomly selected patients (n = 50) with nonI-SPs (photon or proton therapy). The I-SP was contoured on the planning CT and cone beam CTs at 3 timepoints: first, middle, and final treatment (n = 200 scans). I-SPs Hounsfield units (HU), volume, surface area (SA), centroid position relative to prostate centroid, and distance between prostate/rectum centroids were compared on the planning CTs between each cohort. I-SP changes were evaluated on cone beam CTs over courses of treatment. Dosimetric evaluations of plan quality and robustness were performed. I-SP was tested in a phantom to characterize its relative linear stopping power for protons. Results: I-SPs yielded a distinct visible contrast on planning CTs compared to nonI-SPs (HU 138 vs 12, P < .001), allowing delineation on CT alone. The delineated volume and SA of I-SPs were smaller than nonI-SPs (volume 8.9 vs 10.6mL, P < .001; SA28 vs 35 cm(2), P < .001), yet relative spacer position and prostate-rectal separation were similar (P = .79). No significant change in HU, volume, SA, or relative position of the ISPs hydrogel occurred over courses of treatment (all P > .1). Dosimetric analysis concluded there were no significant changes in plan quality or robustness for I-SPs compared to nonI-SPs. The I-SP relative linear stopping power was 1.018, necessitating HU override for proton planning. Conclusions: I-SPs provide a manifest CT contrast, allowing for delineation on planning CT alone with no magnetic resonance imaging necessary. I-SPs radiopacity, size, and relative position remained stable over courses of treatment from 28 to 44 fractions. No changes in plan quality or robustness were seen comparing I-SPs and nonI-SPs. (C) 2021 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

引用

页码：135 / 144

页数：10

共 19 条

[1] Addition of Iodinated Contrast to Rectal Hydrogel Spacer to Facilitate MRI-Independent Target Delineation and Treatment Planning for Prostate Cancer [J].

Atluri, Pramukh S. ;

Gannavarapu, Bhavani S. ;

Timmerman, Robert D. ;

Garant, Aurelie ;

Hannan, Raquibul ;

Folkert, Michael R. ;

Desai, Neil B. .

PRACTICAL RADIATION ONCOLOGY, 2019, 9 (06) :E528-E533

[2] Intensity-modulated fractionated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-B): acute toxicity findings from an international, randomised, open-label, phase 3, non-inferiority trial [J].

Brand, Douglas H. ;

Tree, Alison C. ;

Ostler, Peter ;

van der Voet, Hans ;

Loblaw, Andrew ;

Chu, William ;

Ford, Daniel ;

Tolan, Shaun ;

Jain, Suneil ;

Martin, Alexander ;

Staffurth, John ;

Camilleri, Philip ;

Kancherla, Kiran ;

Frew, John ;

Chan, Andrew ;

Dayes, Ian S. ;

Henderson, Daniel ;

Brown, Stephanie ;

Cruickshank, Clare ;

Burnett, Stephanie ;

Duffton, Aileen ;

Griffin, Clare ;

Hinder, Victoria ;

Morrison, Kirsty ;

Naismith, Olivia ;

Hall, Emma ;

van As, Nicholas .

LANCET ONCOLOGY, 2019, 20 (11) :1531-1543

[3] Randomized Trial of a Hypofractionated Radiation Regimen for the Treatment of Localized Prostate Cancer [J].

Catton, Charles N. ;

Lukka, Himu ;

Gu, Chu-Shu ;

Martin, Jarad M. ;

Supiot, Stephane ;

Chung, Peter W. M. ;

Bauman, Glenn S. ;

Bahary, Jean-Paul ;

Ahmed, Shahida ;

Cheung, Patrick ;

Tai, Keen Hun ;

Wu, Jackson S. ;

Parliament, Matthew B. ;

Tsakiridis, Theodoros ;

Corbett, Tom B. ;

Tang, Colin ;

Dayes, Ian S. ;

Warde, Padraig ;

Craig, Tim K. ;

Julian, Jim A. ;

Levine, Mark N. .

JOURNAL OF CLINICAL ONCOLOGY, 2017, 35 (17) :1884-+

[4] Utilization of Iodinated SpaceOAR Vue™ During Robotic Prostate Stereotactic Body Radiation Therapy (SBRT) to Identify the Rectal-Prostate Interface and Spare the Rectum: A Case Report [J].

Conroy, Dylan ;

Becht, Kelly ;

Forsthoefel, Matthew ;

Pepin, Abigail N. ;

Lei, Siyuan ;

Rashid, Abdul ;

Collins, Brian Timothy ;

Lischalk, Jonathan W. ;

Suy, Simeng ;

Aghdam, Nima ;

Hankins, Ryan Andrew ;

Collins, Sean P. .

FRONTIERS IN ONCOLOGY, 2021, 10

[5] Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial [J].

Dearnaley, David ;

Syndikus, Isabel ;

Mossop, Helen ;

Khoo, Vincent ;

Birtle, Alison ;

Bloomfield, David ;

Graham, John ;

Kirkbride, Peter ;

Logue, John ;

Malik, Zafar ;

Money-Kyrle, Julian ;

O'Sullivan, Joe M. ;

Panades, Miguel ;

Parker, Chris ;

Patterson, Helen ;

Scrase, Christopher ;

Staffurth, John ;

Stockdale, Andrew ;

Tremlett, Jean ;

Bidmead, Margaret ;

Mayles, Helen ;

Naismith, Olivia ;

South, Chris ;

Gao, Annie ;

Cruickshank, Clare ;

Hassan, Shama ;

Pugh, Julia ;

Griffin, Clare ;

Hall, Emma .

LANCET ONCOLOGY, 2016, 17 (08) :1047-1060

[6] Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer [J].

Donovan, J. L. ;

Hamdy, F. C. ;

Lane, J. A. ;

Mason, M. ;

Metcalfe, C. ;

Walsh, E. ;

Blazeby, J. M. ;

Peters, T. J. ;

Holding, P. ;

Bonnington, S. ;

Lennon, T. ;

Bradshaw, L. ;

Cooper, D. ;

Herbert, P. ;

Howson, J. ;

Jones, A. ;

Lyons, N. ;

Salter, E. ;

Thompson, P. ;

Tidball, S. ;

Blaikie, J. ;

Gray, C. ;

Bollina, P. ;

Catto, J. ;

Doble, A. ;

Doherty, A. ;

Gillatt, D. ;

Kockelbergh, R. ;

Kynaston, H. ;

Paul, A. ;

Powell, P. ;

Prescott, S. ;

Rosario, D. J. ;

Rowe, E. ;

Davis, M. ;

Turner, E. L. ;

Martin, R. M. ;

Neal, D. E. .

NEW ENGLAND JOURNAL OF MEDICINE, 2016, 375 (15) :1425-1437

[7] A Multi-Institutional Phase 2 Trial of High-Dose SAbR for Prostate Cancer Using Rectal Spacer [J].

Folkert, Michael R. ;

Zelefsky, Michael J. ;

Hannan, Raquibul ;

Desai, Neil B. ;

Lotan, Yair ;

Laine, Aaron M. ;

Kim, D. W. . Nathan ;

Neufeld, Sarah Hardee ;

Hornberger, Brad ;

Kollmeier, Marisa A. ;

McBride, Sean ;

Ahn, Chul ;

Roehrborn, Claus ;

Timmerman, Robert D. .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2021, 111 (01) :101-109

[8]

Hall WA, 2021, LANCET ONCOL, V22, P11, DOI 10.1016/S1470-2045(20)30639-2

[9] 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer [J].

Hamdy, F. C. ;

Donovan, J. L. ;

Lane, J. A. ;

Mason, M. ;

Metcalfe, C. ;

Holding, P. ;

Davis, M. ;

Peters, T. J. ;

Turner, E. L. ;

Martin, R. M. ;

Oxley, J. ;

Robinson, M. ;

Staffurth, J. ;

Walsh, E. ;

Bollina, P. ;

Catto, J. ;

Doble, A. ;

Doherty, A. ;

Gillatt, D. ;

Kockelbergh, R. ;

Kynaston, H. ;

Paul, A. ;

Powell, P. ;

Prescott, S. ;

Rosario, D. J. ;

Rowe, E. ;

Neal, D. E. .

NEW ENGLAND JOURNAL OF MEDICINE, 2016, 375 (15) :1415-1424

[10] Randomized Trial of Hypofractionated, Dose-Escalated, Intensity-Modulated Radiation Therapy (IMRT) Versus Conventionally Fractionated IMRT for Localized Prostate Cancer [J].

Hoffman, Karen E. ;

Voong, K. Ranh ;

Levy, Lawrence B. ;

Allen, Pamela K. ;

Choi, Seungtaek ;

Schlembach, Pamela J. ;

Lee, Andrew K. ;

McGuire, Sean E. ;

Quynh Nguyen ;

Pugh, Thomas J. ;

Frank, Steven J. ;

Kudchadker, Rajat J. ;

Du, Weiliang ;

Kuban, Deborah A. .

JOURNAL OF CLINICAL ONCOLOGY, 2018, 36 (29) :2943-+

← 1 2 →