open access

Vol 23, No 2 (2018)
Original research articles
Published online: 2018-03-01
Submitted: 2017-09-14
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Does ITV vaginal procedure ensure dosimetric coverage during IMRT of post-operative gynaecological tumours without instructions concerning rectal filling?

Ramona Verges, Alexandra Giraldo, Alejandro Seoane, Elisabet Toral, M. Carmen Ruiz, Ariadna Pons, Jordi Giralt
DOI: 10.1016/j.rpor.2018.01.006
·
Rep Pract Oncol Radiother 2018;23(2):136-142.

open access

Vol 23, No 2 (2018)
Original research articles
Published online: 2018-03-01
Submitted: 2017-09-14

Abstract

Aim

To find out whether the internal target volume (ITV) vaginal procedure ensures dosimetric coverage during intensity-modulated radiation therapy (IMRT) of post-operative gynaecological tumours without instructions on rectal filling.

Background

The ITV vaginal procedure does not necessarily include all movements of the bladder, and does not include changes in the rectal volume. We should know if the vaginal ITV is a useful tool in maintaining CTV coverage during treatment.

Materials and methods

A retrospective analysis of 24 patients treated between July 2012 and July 2014 with adjuvant IMRT for gynaecological cancer. All patients underwent empty and full bladder CT on simulation (CT-planning) and three weeks later (CT-control). ITV displacement was measured and the 3D vector was calculated. ITV coverage was then evaluated by comparing the volume covered by the prescription isodose on both CT's. Patients were asked to have full bladder but they did not follow recommendations for the rectum.

Results

The mean 3D vector was 0.64[[ce:hsp sp="0.25"/]]±[[ce:hsp sp="0.25"/]]0.32[[ce:hsp sp="0.25"/]]cm (0.09–1.30). The mean ITV coverage loss was 5.8[[ce:hsp sp="0.25"/]]±[[ce:hsp sp="0.25"/]]5.7% (0–20.2). We found a significant positive correlation between the 3D vector and the loss of coverage (Pearson correlation, r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.493, 95% CI: 0.111–0.748, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.0144). We did not find any significant correlation between the bladder and rectal parameters with the 3D vector and loss of dosimetric coverage. We found a trend between the maximum rectal diameter in CT-planning and 3D vector (r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.400, 95% CI: −0.004 to 0.692, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.0529).

Conclusion

ITV vaginal procedure contributed to ensuring a good dose coverage without instructions on rectal filling.

Abstract

Aim

To find out whether the internal target volume (ITV) vaginal procedure ensures dosimetric coverage during intensity-modulated radiation therapy (IMRT) of post-operative gynaecological tumours without instructions on rectal filling.

Background

The ITV vaginal procedure does not necessarily include all movements of the bladder, and does not include changes in the rectal volume. We should know if the vaginal ITV is a useful tool in maintaining CTV coverage during treatment.

Materials and methods

A retrospective analysis of 24 patients treated between July 2012 and July 2014 with adjuvant IMRT for gynaecological cancer. All patients underwent empty and full bladder CT on simulation (CT-planning) and three weeks later (CT-control). ITV displacement was measured and the 3D vector was calculated. ITV coverage was then evaluated by comparing the volume covered by the prescription isodose on both CT's. Patients were asked to have full bladder but they did not follow recommendations for the rectum.

Results

The mean 3D vector was 0.64[[ce:hsp sp="0.25"/]]±[[ce:hsp sp="0.25"/]]0.32[[ce:hsp sp="0.25"/]]cm (0.09–1.30). The mean ITV coverage loss was 5.8[[ce:hsp sp="0.25"/]]±[[ce:hsp sp="0.25"/]]5.7% (0–20.2). We found a significant positive correlation between the 3D vector and the loss of coverage (Pearson correlation, r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.493, 95% CI: 0.111–0.748, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.0144). We did not find any significant correlation between the bladder and rectal parameters with the 3D vector and loss of dosimetric coverage. We found a trend between the maximum rectal diameter in CT-planning and 3D vector (r[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.400, 95% CI: −0.004 to 0.692, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.0529).

Conclusion

ITV vaginal procedure contributed to ensuring a good dose coverage without instructions on rectal filling.

Get Citation

Keywords

Vaginal ITV; ITV coverage; Organ motion; Bladder filling; Rectal filling

About this article
Title

Does ITV vaginal procedure ensure dosimetric coverage during IMRT of post-operative gynaecological tumours without instructions concerning rectal filling?

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 2 (2018)

Pages

136-142

Published online

2018-03-01

DOI

10.1016/j.rpor.2018.01.006

Bibliographic record

Rep Pract Oncol Radiother 2018;23(2):136-142.

Keywords

Vaginal ITV
ITV coverage
Organ motion
Bladder filling
Rectal filling

Authors

Ramona Verges
Alexandra Giraldo
Alejandro Seoane
Elisabet Toral
M. Carmen Ruiz
Ariadna Pons
Jordi Giralt

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