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• W2019352818 abstract "Purpose/Objective: To determine whether appropriately parameterized cluster models (Thames et al., IJROBP 59:1491-1504,2004) can accurately predict rectal bleeding following IMRT treatment of T1-T2 prostate cancer. Materials/Methods: Since inception of treatment of prostate cancer patients with IMRT at our institution (summer 2000) there have been 15 cases of rectal bleeding (∼5% rate). 54 controls were available with > 3 y follow-up. 9 cases with comorbidities possibly predisposing to rectal bleeding (rectal bleeding 1, diabetes 4, hemorrhoids 6) were excluded, leaving 9 cases for whom matching controls were to be found. For each case and control, the total dose to points on the rectal wall was estimated by interpolation from 3D dose distributions. Each case was matched with the control whose absolute dose-wall histogram (DWH) for rectal wall agreed most closely, as assessed by mean squared difference over the dose range 0–90 Gy, at intervals of 2.5 Gy (Figure). For each pair of dose-density parameters (b1,b2), the distribution of cluster sizes for 2-connectivity was calculated for each of the 18 inhomogeneous dose-wall distributions as described in Thames et al. (2004). The likelihood that mean maximum cluster size (cases) > mean maximum cluster size (controls) was maximized in terms of the dose-density parameters b1 and b2. Results: Among the 800 (b1,b2) pairs investigated, 40 pairs (5%) resulted in the largest likelihood values. For each of these points, the mean maximum cluster size of the cases was higher than that of the closely matched controls (Figure) in 7/9 or 8/9 comparisons. The ratio b1/b2 corresponding to the highest likelihood values was very well determined by the data, and corresponds to D50 = 40.4 Gy. This is in the intermediate range of doses delivered to the rectal walls of cases and controls, as was the similar estimate D50=32.4 Gy obtained by Tucker et al. (IJROBP 59:353–365, 2004). These results suggest the hypothesis that details of the dose distribution in the low-to-intermediate (not the high-) dose range are decisive in determining the probability of rectal complications. Conclusions: Cluster models are effective summaries of the biological and physical characteristics of inhomogeneous dose distributions to the rectal wall. They contain information pertaining to the probability of rectal bleeding after treatment of prostate cancer by IMRT that is independent of the information contained in DVHs." @default.
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• W2019352818 date "2005-10-01" @default.
• W2019352818 modified "2023-09-27" @default.
• W2019352818 title "A Case-Control Study of Cluster Size as Predictor of Rectal Bleeding in T1-T2 Prostate Cancer Patients Treated by IMRT" @default.
• W2019352818 doi "https://doi.org/10.1016/j.ijrobp.2005.07.557" @default.
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