Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies

The purpose of this work is to determine appropriate radiation therapy beam margins to account for intrafraction prostate translations for use with real-time electromagnetic position monitoring and correction strategies. Motion was measured continuously in 35 patients over 1157 fractions at 5 instit...

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Main Authors: Dale W. Litzenberg, James M. Balter, Scott W. Hadley, Daniel A. Hamstra, Twyla R. Willoughby, Patrick A. Kupelian, Toufik Djemil, Arul Mahadevan, Shirish Jani, Geoffrey Weinstein, Timothy Solberg, Charles Enke, Lisa Levine, Howard M. Sandler
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Prostate Cancer
Online Access:http://dx.doi.org/10.1155/2012/130579
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author Dale W. Litzenberg
James M. Balter
Scott W. Hadley
Daniel A. Hamstra
Twyla R. Willoughby
Patrick A. Kupelian
Toufik Djemil
Arul Mahadevan
Shirish Jani
Geoffrey Weinstein
Timothy Solberg
Charles Enke
Lisa Levine
Howard M. Sandler
author_facet Dale W. Litzenberg
James M. Balter
Scott W. Hadley
Daniel A. Hamstra
Twyla R. Willoughby
Patrick A. Kupelian
Toufik Djemil
Arul Mahadevan
Shirish Jani
Geoffrey Weinstein
Timothy Solberg
Charles Enke
Lisa Levine
Howard M. Sandler
author_sort Dale W. Litzenberg
collection DOAJ
description The purpose of this work is to determine appropriate radiation therapy beam margins to account for intrafraction prostate translations for use with real-time electromagnetic position monitoring and correction strategies. Motion was measured continuously in 35 patients over 1157 fractions at 5 institutions. This data was studied using van Herk's formula of (αΣ+γσ') for situations ranging from no electromagnetic guidance to automated real-time corrections. Without electromagnetic guidance, margins of over 10 mm are necessary to ensure 95% dosimetric coverage while automated electromagnetic guidance allows the margins necessary for intrafraction translations to be reduced to submillimeter levels. Factors such as prostate deformation and rotation, which are not included in this analysis, will become the dominant concerns as margins are reduced. Continuous electromagnetic monitoring and automated correction have the potential to reduce prostate margins to 2-3 mm, while ensuring that a higher percentage of patients (99% versus 90%) receive a greater percentage (99% versus 95%) of the prescription dose.
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spelling doaj-art-bfb5eaaf507e4008865d6ed299b747862025-08-20T02:19:26ZengWileyProstate Cancer2090-31112090-312X2012-01-01201210.1155/2012/130579130579Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction StrategiesDale W. Litzenberg0James M. Balter1Scott W. Hadley2Daniel A. Hamstra3Twyla R. Willoughby4Patrick A. Kupelian5Toufik Djemil6Arul Mahadevan7Shirish Jani8Geoffrey Weinstein9Timothy Solberg10Charles Enke11Lisa Levine12Howard M. Sandler13Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI 48109-5010, USADepartment of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI 48109-5010, USADepartment of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI 48109-5010, USADepartment of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI 48109-5010, USAM. D. Anderson Cancer Center Orlando, Orlando, FL 32806, USAUCLA, Los Angeles, CA 90095, USACleveland Clinic Foundation, Cleveland, OH 44195, USACleveland Clinic Foundation, Cleveland, OH 44195, USASharp Health Care Hospital, San Diego, CA 92123, USASharp Health Care Hospital, San Diego, CA 92123, USAUniversity of Texas Southwestern Medical Center, Dallas, TX 75390, USANebraska Medical Center, Omaha, NE 68198, USACalypso Medical Technologies Inc., Seattle, WA 98121, USACedars-Sinai, Los Angeles, CA 90048, USAThe purpose of this work is to determine appropriate radiation therapy beam margins to account for intrafraction prostate translations for use with real-time electromagnetic position monitoring and correction strategies. Motion was measured continuously in 35 patients over 1157 fractions at 5 institutions. This data was studied using van Herk's formula of (αΣ+γσ') for situations ranging from no electromagnetic guidance to automated real-time corrections. Without electromagnetic guidance, margins of over 10 mm are necessary to ensure 95% dosimetric coverage while automated electromagnetic guidance allows the margins necessary for intrafraction translations to be reduced to submillimeter levels. Factors such as prostate deformation and rotation, which are not included in this analysis, will become the dominant concerns as margins are reduced. Continuous electromagnetic monitoring and automated correction have the potential to reduce prostate margins to 2-3 mm, while ensuring that a higher percentage of patients (99% versus 90%) receive a greater percentage (99% versus 95%) of the prescription dose.http://dx.doi.org/10.1155/2012/130579
spellingShingle Dale W. Litzenberg
James M. Balter
Scott W. Hadley
Daniel A. Hamstra
Twyla R. Willoughby
Patrick A. Kupelian
Toufik Djemil
Arul Mahadevan
Shirish Jani
Geoffrey Weinstein
Timothy Solberg
Charles Enke
Lisa Levine
Howard M. Sandler
Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies
Prostate Cancer
title Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies
title_full Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies
title_fullStr Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies
title_full_unstemmed Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies
title_short Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies
title_sort prostate intrafraction translation margins for real time monitoring and correction strategies
url http://dx.doi.org/10.1155/2012/130579
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