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- W2107266201 abstract "To determine appropriate dosimetric prostate margins to account for initial translations and rotations measured with electromagnetic tracking. On an IRB approved protocol, 26 patients with histologically confirmed adenocarcinoma of the prostate were treated using the Calypso® 4D Localization System wherein 3 Beacon® electromagnetic transponders are implanted. Patients with favorable-to-intermediate risk cancer: T1c-T2b, Gleason score ≤ 7, and PSA ≤ 15 ng/ml, were eligible. The prostate was localized daily based on pre-determined transponder positions relative to isocenter on the treatment planning CT, prior to beginning continuous tracking. The initial translations and rotations were obtained at the beginning of each tracking session. These rotations and residual translations were then used to study the dosimetric impact on prostate coverage. IMRT treatment plans meeting RTOG0126 dosimetric criteria (minimum dose of 79 Gy to 100% of the CTV) were created for each patient with 2 mm, 3 mm and 5 mm CTV-to-PTV expansions, where the CTV was the contoured prostate gland. For each fraction, the patient model and contours were translated and rotated to the measured position and the dose distribution to the prostate (CTV) was accumulated for all fractions of each patient. This was repeated for plans with 2, 3 and 5 mm PTV expansions to determine the margin necessary to ensure dosimetric coverage to the CTV. The (average+/-standard deviation) translations observed in the Left-Right direction were TLR = (0.00 +/- 0.15) cm, in the Anterior-Posterior direction were TAP = (-0.02 +/- 0.08) cm, and in the Superior-Inferior direction were TSI = (-0.01 +/- 0.13) cm. The (average+/-standard deviation) rotations observed about the Left-Right axis were RLR = (-0.7 +/- 6.9) degrees, about the Anterior-Posterior axis were RAP = (-0.2 +/- 3.1) degrees, and about the Superior-Inferior axis were RSI = (0.7 +/- 2.1) degrees. The impact of translations and rotations reduced the minimum CTV dose to 93% for a 2 mm margin, 99% for a 3 mm margin, and 100% for a 5 mm margin, At the beginning of each tracking session, the translations have been largely removed leaving predominantly the initial rotational setup error. This preliminary study indicates that a 3 mm margin is needed to provide 99% of the prescribed minimum dose to the CTV volume for the initial rotations and residual translations observed in this cohort of patients." @default.
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- W2107266201 date "2009-11-01" @default.
- W2107266201 modified "2023-09-27" @default.
- W2107266201 title "Prostate Margins for Daily Rotations and Residual Translations" @default.
- W2107266201 doi "https://doi.org/10.1016/j.ijrobp.2009.07.715" @default.
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