TY - JOUR
T1 - Acute toxicity in hypofractionated/stereotactic prostate radiotherapy of elderly patients
T2 - Use of the image-guided radio therapy (IGRT) clarity system
AU - Di Franco, Rossella
AU - Borzillo, Valentina
AU - Alberti, Domingo
AU - Ametrano, Gianluca
AU - Petito, Angela
AU - Coppolaro, Andrea
AU - Tarantino, Ilaria
AU - Rossetti, Sabrina
AU - Pignata, Sandro
AU - Iovane, Gelsomina
AU - Perdona, Sisto
AU - Quarto, Giuseppe
AU - Grimaldi, Giovanni
AU - Izzo, Alessandro
AU - Castaldo, Luigi
AU - Muscariello, Raffaele
AU - Serra, Marcello
AU - Facchini, Gaetano
AU - Muto, Paolo
N1 - Publisher Copyright:
© 2021 International Institute of Anticancer Research. All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - Background: The use of intra-fractional monitoring and correction of prostate position with the Image Guided Radio Therapy (IGRT) system can increase the spatial accuracy of dose delivery. Clarity is a system used for intrafraction prostate-motion management, it provides a real-time visualization of prostate with a transperineal ultrasound. The aim of this study was to evaluate the use of Clarity-IGRT on proper intrafraction alignment and monitoring, its impact on Planning Tumor Volume margin and on urinary and rectal toxicity in elderly patients not eligible for surgery. Patients and Methods: Twenty-five elderly prostate cancer patients, median age=75 years (range=75-90 years) were treated with Volumetric Radiotherapy and Clarity-IGRT using 3 different schemes: A) 64.5/72 Gray (Gy) in 30 fractions on prostate and seminal vesicles (6 patients); B) 35 Gy in 5 fractions on prostate and seminal vesicles (12 patients); C): 35 Gy in 5 fractions on prostate (7 patients). Ultrasound identification of the overlapped structures to the detected ones during simulation has been used in each session. A specific software calculates direction and entity of necessary shift to obtain the perfect match. The average misalignment in the three-dimensional space has been determined and shown in a box-plot. Results: All patients completed treatment with mild-moderate toxicity. During treatment, genitourinary toxicity was 32% Grade 1; 4% Grade 2, rectal was 4% Grade 1. At follow-up of 3 months, genitourinary toxicity was 20% Grade 1; 4% Grade 2, rectal toxicity was 4% Grade 2. At follow-up of 6 months, genitourinary toxicity was 4% Grade 1; 4% Grade 2. Rectal toxicity was 4% Grade 2. Conclusion: Radiotherapy with the Clarity System allows a reduction of PTV margins, the amount of fractions can be reduced increasing the total dose, not exacerbating urinary and rectal toxicity with greater patient's compliance.
AB - Background: The use of intra-fractional monitoring and correction of prostate position with the Image Guided Radio Therapy (IGRT) system can increase the spatial accuracy of dose delivery. Clarity is a system used for intrafraction prostate-motion management, it provides a real-time visualization of prostate with a transperineal ultrasound. The aim of this study was to evaluate the use of Clarity-IGRT on proper intrafraction alignment and monitoring, its impact on Planning Tumor Volume margin and on urinary and rectal toxicity in elderly patients not eligible for surgery. Patients and Methods: Twenty-five elderly prostate cancer patients, median age=75 years (range=75-90 years) were treated with Volumetric Radiotherapy and Clarity-IGRT using 3 different schemes: A) 64.5/72 Gray (Gy) in 30 fractions on prostate and seminal vesicles (6 patients); B) 35 Gy in 5 fractions on prostate and seminal vesicles (12 patients); C): 35 Gy in 5 fractions on prostate (7 patients). Ultrasound identification of the overlapped structures to the detected ones during simulation has been used in each session. A specific software calculates direction and entity of necessary shift to obtain the perfect match. The average misalignment in the three-dimensional space has been determined and shown in a box-plot. Results: All patients completed treatment with mild-moderate toxicity. During treatment, genitourinary toxicity was 32% Grade 1; 4% Grade 2, rectal was 4% Grade 1. At follow-up of 3 months, genitourinary toxicity was 20% Grade 1; 4% Grade 2, rectal toxicity was 4% Grade 2. At follow-up of 6 months, genitourinary toxicity was 4% Grade 1; 4% Grade 2. Rectal toxicity was 4% Grade 2. Conclusion: Radiotherapy with the Clarity System allows a reduction of PTV margins, the amount of fractions can be reduced increasing the total dose, not exacerbating urinary and rectal toxicity with greater patient's compliance.
KW - Hypofractionated radiotherapy
KW - Prostate cancer
KW - Radiotherapy
KW - Tracking
KW - Ultrasound
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U2 - 10.21873/invivo.12447
DO - 10.21873/invivo.12447
M3 - Article
C2 - 33910872
AN - SCOPUS:85105067872
VL - 35
SP - 1849
EP - 1856
JO - In Vivo
JF - In Vivo
SN - 0258-851X
IS - 3
ER -