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Article

Dosimetric Evaluation of the Inter-Fraction Motion of Organs at Risk in SBRT for Nodal Oligometastatic Prostate Cancer

by
Francesco La Fauci
1,†,
Matteo Augugliaro
2,‡,
Giovanni Carlo Mazzola
2,3,
Stefania Comi
1,
Matteo Pepa
2,§,
Mattia Zaffaroni
2,
Maria Giulia Vincini
2,*,
Giulia Corrao
2,3,
Francesco Alessandro Mistretta
3,4,
Stefano Luzzago
3,4,
Cristiana Fodor
2,
Gennaro Musi
3,4,
Salvatore Gallo
5,
Giuseppe Petralia
3,6,
Ottavio De Cobelli
3,4,
Roberto Orecchia
7,
Federica Cattani
1,‖,
Giulia Marvaso
2,3,‖ and
Barbara Alicja Jereczek-Fossa
2,3,‖
1
Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
2
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
3
Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
4
Department of Urology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
5
Department of Physics “Aldo Pontremoli”, University of Milan, 20133 Milan, Italy
6
Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
7
Scientific Directorate, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
*
Author to whom correspondence should be addressed.
†
Current address: Humanitas Research Hospital, 20089 Rozzano, Italy.
‡
Current address: Radiation Therapy Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
§
Current address: Centro Nazionale di Adroterapia Oncologica (CNAO), 27100 Pavia, Italy.
‖
Co-last authors.
Appl. Sci. 2022, 12(21), 10949; https://doi.org/10.3390/app122110949
Submission received: 10 September 2022 / Revised: 19 October 2022 / Accepted: 24 October 2022 / Published: 28 October 2022
(This article belongs to the Special Issue Developments of Diagnostic Imaging Applied in Radiotherapy)
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Abstract

In this paper, we aim to evaluate the entity of inter-fraction organ motion and deformation in stereotactic body radiotherapy (SBRT) treatments for nodal oligometastatic prostate cancer (PCa). Thirty-three patients with lymph nodes showing oligometastatic PCa treated with SBRT were included. Organs at risk (OARs) were delineated using both simulation computer tomography (s-CT) and daily cone beam CTs (CBCTs) using the Raystation planning system. For each OAR, the union volume (UV) between all the CBCTs and s-CT was computed. An expanded volume (EV) of the s-CT OARs was applied using six different margins (3, 5, 8, 10, 15, and 20 mm). A percentage volume (V%) was computed to assess the intersection between each EV and UV. The OAR deformation and motion were further evaluated using the dice similarity coefficient (DSC) and mean distance to agreement (Mean_DA). The percentage maximum dose variations for all the OARs were estimated. A recalculation with higher dose prescriptions was performed by prescribing 36 Gy/3 fx, as well as 45 Gy/3 fx. The cauda showed the highest matching (DSC = 0.72; Mean_DA = 0.14 cm), and the colon showed the lowest one (DSC = 0.37; Mean_DA = 0.44 cm). The minimum margin, which ensured a V% > 95%, was 3 mm (97.5%) for the cauda and 15 mm (96.6%) for the colon. All the OARs reached the compliance of the constraints in each session. Regarding 36 Gy-plans, the ileum punctual compliance Dmax failed in 58.8% of patients, and it failed in 70.6% of the patients for the ileum, 7.14% for the colon, and 12.5% for the bladder in the case of 45 Gy-plans. This study is an ancillary study of the RADIOSA clinical trial (AIRC IG-22159) and can be used as a benchmark for dose escalation.
Keywords: oligometastatic prostate cancer; stereotactic body radiotherapy; computed tomography; planning; inter fraction; organ motion oligometastatic prostate cancer; stereotactic body radiotherapy; computed tomography; planning; inter fraction; organ motion

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MDPI and ACS Style

La Fauci, F.; Augugliaro, M.; Mazzola, G.C.; Comi, S.; Pepa, M.; Zaffaroni, M.; Vincini, M.G.; Corrao, G.; Mistretta, F.A.; Luzzago, S.; et al. Dosimetric Evaluation of the Inter-Fraction Motion of Organs at Risk in SBRT for Nodal Oligometastatic Prostate Cancer. Appl. Sci. 2022, 12, 10949. https://doi.org/10.3390/app122110949

AMA Style

La Fauci F, Augugliaro M, Mazzola GC, Comi S, Pepa M, Zaffaroni M, Vincini MG, Corrao G, Mistretta FA, Luzzago S, et al. Dosimetric Evaluation of the Inter-Fraction Motion of Organs at Risk in SBRT for Nodal Oligometastatic Prostate Cancer. Applied Sciences. 2022; 12(21):10949. https://doi.org/10.3390/app122110949

Chicago/Turabian Style

La Fauci, Francesco, Matteo Augugliaro, Giovanni Carlo Mazzola, Stefania Comi, Matteo Pepa, Mattia Zaffaroni, Maria Giulia Vincini, Giulia Corrao, Francesco Alessandro Mistretta, Stefano Luzzago, and et al. 2022. "Dosimetric Evaluation of the Inter-Fraction Motion of Organs at Risk in SBRT for Nodal Oligometastatic Prostate Cancer" Applied Sciences 12, no. 21: 10949. https://doi.org/10.3390/app122110949

APA Style

La Fauci, F., Augugliaro, M., Mazzola, G. C., Comi, S., Pepa, M., Zaffaroni, M., Vincini, M. G., Corrao, G., Mistretta, F. A., Luzzago, S., Fodor, C., Musi, G., Gallo, S., Petralia, G., De Cobelli, O., Orecchia, R., Cattani, F., Marvaso, G., & Jereczek-Fossa, B. A. (2022). Dosimetric Evaluation of the Inter-Fraction Motion of Organs at Risk in SBRT for Nodal Oligometastatic Prostate Cancer. Applied Sciences, 12(21), 10949. https://doi.org/10.3390/app122110949

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