Positional Reproducibility and Effects of a Rectal Balloon in Prostate Cancer Radiotherapy.
10.3346/jkms.2009.24.5.894
- Author:
Jae Ho CHO
1
;
Chang Geol LEE
;
Dae Ryong KANG
;
Jooho KIM
;
Sangkyu LEE
;
Chang Ok SUH
;
Jinsil SEONG
;
Yang Gun SUH
;
Ikjae LEE
;
Gwi Eon KIM
Author Information
1. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea. gekim@yuhs.ac
- Publication Type:Original Article
- Keywords:
Rectal Balloon;
Prostatic Neoplasms;
Radiotherapy, Intensity-Modulated;
3D Conformal Radiotherapy;
Acute Toxicity
- MeSH:
Balloon Dilatation/*methods;
Dose-Response Relationship, Radiation;
Humans;
Male;
Neoplasm Staging;
Prostatic Neoplasms/*radiotherapy;
Radiotherapy, Conformal;
Radiotherapy, Intensity-Modulated;
*Rectum;
Tomography, X-Ray Computed;
Treatment Outcome
- From:Journal of Korean Medical Science
2009;24(5):894-903
- CountryRepublic of Korea
- Language:English
-
Abstract:
Despite the increasing use of the rectal balloon in prostate cancer radiotherapy, many issues still remain to be verified objectively including its positional reproducibility and relevance to treatment morbidity. We have developed a custom rectal balloon that has a scale indicating the depth of insertion and dilates symmetrically ensuring positional reproducibility. Fifty patients with prostate cancer treated by definitive 3D-conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) with rectal balloon were analyzed. Each of first five patients undergone computed tomography (CT) three times with a rectal balloon. The positional reproducibility was tested by Intraclass Correlation Coefficient (ICC) from the CT-to-CT fusion images. Planning variables and clinical acute toxicities were compared between when or not applying balloon. An ICC of greater than 0.9 in all directions revealed an excellent reproducibility of the balloon. Rectal balloon improved considerably the mean dose and V(45Gy)-V(65Gy) in plan comparison, and especially in 3D-CRT the rectal volume exposed to more than 60 Gy dropped from 41.3% to 19.5%. Clinically, the balloon lowered acute toxicity, which was lowest when both the balloon and IMRT were applied simultaneously. The rectal balloon carries excellent reproducibility and reduces acute toxicity in 3D-CRT and IMRT for prostate cancer.
