Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 14:11:690422.
doi: 10.3389/fonc.2021.690422. eCollection 2021.

Studies of Intra-Fraction Prostate Motion During Stereotactic Irradiation in First Irradiation and Re-Irradiation

Alexandre Taillez  1   2 , Andre-Michel Bimbai  3 , Thomas Lacornerie  4 , Marie-Cecile Le Deley  3 , Eric F Lartigau  1   2   5 , David Pasquier  1   2   5
Affiliations

Studies of Intra-Fraction Prostate Motion During Stereotactic Irradiation in First Irradiation and Re-Irradiation

Alexandre Taillez et al. Front Oncol. .

Abstract

Background: Understanding intra-fractional prostate motions is crucial for stereotactic body radiation therapy (SBRT). No studies have focused on the intra-fractional prostate motions during re-irradiation with SBRT. The objective was to evaluate these translational and rotational motions in primary treated patients and in the context of re-irradiation.

Methods: From January 2011 to March 2020, 162 patients with histologically proven prostate cancer underwent prostate SBRT, including 58 as part of a re-irradiation treatment. We used the continuous coordinates of the fiducial markers collected by an orthogonal X-ray dual-image monitoring system. The translations and rotations of the prostate were calculated. Prostate deviations representing overall movement was defined as the length of the 3D-vectors.

Results: A total of 858 data files were analyzed. The deviations over time in the group of primary treated patients were significantly larger than that of the group of re-irradiation, leading to a mean deviation of 2.73 mm (SD =1.00) versus 1.90 mm (SD =0.79), P<0.001. In the re-irradiation group, we identified displacements of -0.05 mm (SD =1.53), 0.20 mm (SD =1.46); and 0.42 mm (SD =1.24) in the left-right, superior-inferior and anterior-posterior planes. Overall, we observed increasing deviations over the first 30 min followed by a stabilization related to movements in the three translational axes.

Conclusion: This is the first study to focus on intrafraction prostate motions in the context of re-irradiation. We observed that intra-fraction prostate motions persisted in the setting of re-irradiation, although they showed a significant reduction when compared with the first irradiation. These results will help to better estimate random errors during SBRT treatment of intra-prostatic recurrence after irradiation.

Keywords: dose hypofractionation; motion; prostatic neoplasms; re-irradiation; salvage therapy; stereotactic radiation therapy; tracking.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Curve of the mean deviation per 10-minute interval in each treatment group (primary irradiation and re-irradiation).
Figure 2
Figure 2
Distribution of the deviation according to time in 10-minute intervals, across all patients.
Figure 3
Figure 3
(A) Translational motions Supero-Inferior, left-Right and antero-posterior expressed in mm. (B) Rational motions Roll, Pitch and Yaw expressed in degrees. Changes over time of translational and rotational motions of the prostate, in all patients. On each figure, mean values and standard deviations, by 10-minute time interval, overall considering both groups together.
See this image and copyright information in PMC

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA A Cancer J Clin (2021) 71(3):209–49. 10.3322/caac.21660 - DOI - PubMed
    1. Mohler JL, Antonarakis ES, Armstrong AJ, D’Amico AV, Davis BJ, Dorff T, et al. . Prostate Cancer, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw (2019) 17:479–505. 10.6004/jnccn.2019.0023 - DOI - PubMed
    1. Morgan SC, Hoffman K, Loblaw DA, Buyyounouski MK, Patton C, Barocas D, et al. . Hypofractionated Radiation Therapy for Localized Prostate Cancer: Executive Summary of an ASTRO, ASCO, and AUA Evidence-Based Guideline. Pract Radiat Oncol (2018) 8:354–60. 10.1016/j.prro.2018.08.002 - DOI - PubMed
    1. King CR, Freeman D, Kaplan I, Fuller D, Bolzicco G, Collins S, et al. . Stereotactic Body Radiotherapy for Localized Prostate Cancer: Pooled Analysis From a Multi-Institutional Consortium of Prospective Phase II Trials. Radiother Oncol (2013) 109:217–21. 10.1016/j.radonc.2013.08.030 - DOI - PubMed
    1. Kishan AU, Dang A, Katz AJ, Mantz CA, Collins SP, Aghdam N, et al. . Long-Term Outcomes of Stereotactic Body Radiotherapy for Low-Risk and Intermediate-Risk Prostate Cancer. JAMA Netw Open (2019) 2:e188006. 10.1001/jamanetworkopen.2018.8006 - DOI - PMC - PubMed

LinkOut - more resources