Bladder dose constraints in case of conformational radiotherapy/intensity-modulated radiotherapy and stereotactic radiotherapy are reported from the literature, in particular from the French radiotherapy society RECORAD recommendations, according to the treated pelvic tumor sites. The dose-volume effect on urinary toxicity is not clearly demonstrated, making difficult to establish absolute dose constraints for the bladder. In case of high-dose prostate cancer radiotherapy, the bladder dose constraints are: V60Gy<50% and maximum dose<80Gy for standard fractionation and V60Gy<5%, V48Gy<25% and V41Gy<50% for moderate hypofractionation (20 fractions of 3Gy). In case of prostate stereotactic radiotherapy (five fractions of 7.25Gy), the most frequent dose constraints in the literature are V37Gy<10cm and V18Gy<40%. In case of conformational radiotherapy of cervix cancer, postoperative endometrium, anal canal and rectum, the recommendations are V40Gy<40% and D2% lower than the prescribed dose.
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http://dx.doi.org/10.1016/j.canrad.2017.07.038 | DOI Listing |
Adv Radiat Oncol
February 2025
Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Purpose: Ultrahypofractionation presents challenges for a subset of high-risk prostate cancer patients due to the large planning target volume (PTV) margin required for the seminal vesicles. Online adaptive radiation therapy could potentially reduce this margin. This paper focuses on the development, preclinical validation, and clinical testing of online adaptive robotic stereotactic body radiation therapy for this patient group.
View Article and Find Full Text PDFCancers (Basel)
January 2025
Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy.
Background: Radiotherapy for thymoma is delivered post-operatively in selected cases. Given the particular location of the thymic bed and the excellent prognosis, late cardiac toxicities may be an issue. The purpose of this retrospective dosimetric study is to investigate whether intensity-modulated proton beam therapy (IMPT) compared to photon therapy could better spare cardiac substructures, given prespecified dose constraints.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
January 2025
Department of Radiation Oncology, West Virginia University, Morgantown, WV, USA.
Purpose: A single phase III trial has demonstrated that prostate radiotherapy with a focal, intra-prostatic "microboost" can improve disease control without an overall increase in toxicity. It is unclear how these results generalize to other treatment schedules and protocols.
Methods: A systematic search of PubMed and the Cochrane Review was performed for studies published on or before September 1, 2023.
Curr Oncol
January 2025
Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
(1) Background: Volumetric modulated arc therapy (VMAT) can deliver more accurate dose distribution and reduce radiotherapy-induced toxicities for postoperative cervical and endometrial cancer. This study aims to retrospectively analyze the relationship between dosimetric parameters of organs at risk (OARs) and acute toxicities and provide suggestions for the dose constraints. (2) Methods: A total of 164 postoperative cervical and endometrial cancer patients were retrospectively analyzed, and the endpoints were grade ≥ 2 acute urinary toxicity (AUT) and acute lower gastrointestinal toxicity (ALGIT).
View Article and Find Full Text PDFCureus
December 2024
Department of Radiology, Aichi Medical University, Nagakute, JPN.
Purpose In linac-based stereotactic radiosurgery (SRS) utilizing a multileaf collimator (MLC) for brain metastases (BMs), a volumetric-modulated arc (VMA) technique is indispensable for generating a suitable dose distribution with efficient planning and delivery. However, the optimal calculation grid spacing (GS) and statistical uncertainty (SU) of the Monte Carlo algorithm for VMA optimization have yet to be determined. This planning study aimed to examine the impacts of GS and GU settings on VMA-based SRS planning and to find the optimal combination for templating.
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