Dealing with rectum motion during radiotherapy: How can we anticipate it?
Introduction: Intra- and inter-fraction rectum motion is important for pelvic radiotherapy (RT). This study assesses how RT session duration, the presence or the absence of an intra-rectal tumour, and the distance from the anorectal junction (ARJd) impact rectal motion. Materials and methods: Analys...
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Elsevier
2024-12-01
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| Series: | Technical Innovations & Patient Support in Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405632424000441 |
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| author | Julien Pierrard Sofie Heylen Ad Vandermeulen Geneviève Van Ooteghem |
| author_facet | Julien Pierrard Sofie Heylen Ad Vandermeulen Geneviève Van Ooteghem |
| author_sort | Julien Pierrard |
| collection | DOAJ |
| description | Introduction: Intra- and inter-fraction rectum motion is important for pelvic radiotherapy (RT). This study assesses how RT session duration, the presence or the absence of an intra-rectal tumour, and the distance from the anorectal junction (ARJd) impact rectal motion. Materials and methods: Analyses used cone-beam computed tomographies (CBCTs) from RT patients treated for rectal and prostate cancer. Three structures were evaluated: (1) the entire rectum in patients without a rectal tumour (RectumProstate); (2) the non-invaded portion (RectumRectum) and (3) the tumour-invaded portion (RectumTumour) in rectal cancer patients.Intrafraction motion was assessed using the Hausdorff distance 95% and the Mean distance-to-agreement between structures delineated on the first CBCT and the 2 subsequent CBCTs within a same RT session. Interfraction motion was quantified by comparing structures delineated on the planning-CT and the first CBCT of each session.Linear mixed model evaluated rectum motion in relation to time, tumour presence, and ARJd, respectively. Results: We included 10 patients with and 10 without rectal cancer, collecting 385 CBCTs. A significant correlation (p < 0.05) between rectum motion and RT session duration was found. Intrafraction motion was significantly higher in prostate cancer patients (RectumProstate motion > RectumRectum and RectumTumour, p < 0.01). For interfraction motion, only the mean distance to agreement was significantly higher for RectumProstate (p < 0.05). Motion increased significantly with ARJd for all three structures (p < 0.001). Conclusions: Session duration, absence of a tumour, and ARJd are associated with larger intra- and interfraction rectal motion. This highlights the need for tailored RT treatment, including online-adaptive RT, to manage intra- and interfraction variations. Rectal motion should be handled differently for patients with prostate cancer and those with rectal cancer. |
| format | Article |
| id | doaj-art-6593e7f74b8e4606a3a687d0c3f6a3a4 |
| institution | OA Journals |
| issn | 2405-6324 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Technical Innovations & Patient Support in Radiation Oncology |
| spelling | doaj-art-6593e7f74b8e4606a3a687d0c3f6a3a42025-08-20T02:35:51ZengElsevierTechnical Innovations & Patient Support in Radiation Oncology2405-63242024-12-013210027710.1016/j.tipsro.2024.100277Dealing with rectum motion during radiotherapy: How can we anticipate it?Julien Pierrard0Sofie Heylen1Ad Vandermeulen2Geneviève Van Ooteghem3UCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium; Department of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Corresponding author at: UCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Avenue Hippocrate 54, boîte B1.54.07, Brussels, Belgium.Department of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumDepartment of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumUCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium; Department of Radiation Oncology, Cliniques Universitaires Saint-Luc, Brussels, BelgiumIntroduction: Intra- and inter-fraction rectum motion is important for pelvic radiotherapy (RT). This study assesses how RT session duration, the presence or the absence of an intra-rectal tumour, and the distance from the anorectal junction (ARJd) impact rectal motion. Materials and methods: Analyses used cone-beam computed tomographies (CBCTs) from RT patients treated for rectal and prostate cancer. Three structures were evaluated: (1) the entire rectum in patients without a rectal tumour (RectumProstate); (2) the non-invaded portion (RectumRectum) and (3) the tumour-invaded portion (RectumTumour) in rectal cancer patients.Intrafraction motion was assessed using the Hausdorff distance 95% and the Mean distance-to-agreement between structures delineated on the first CBCT and the 2 subsequent CBCTs within a same RT session. Interfraction motion was quantified by comparing structures delineated on the planning-CT and the first CBCT of each session.Linear mixed model evaluated rectum motion in relation to time, tumour presence, and ARJd, respectively. Results: We included 10 patients with and 10 without rectal cancer, collecting 385 CBCTs. A significant correlation (p < 0.05) between rectum motion and RT session duration was found. Intrafraction motion was significantly higher in prostate cancer patients (RectumProstate motion > RectumRectum and RectumTumour, p < 0.01). For interfraction motion, only the mean distance to agreement was significantly higher for RectumProstate (p < 0.05). Motion increased significantly with ARJd for all three structures (p < 0.001). Conclusions: Session duration, absence of a tumour, and ARJd are associated with larger intra- and interfraction rectal motion. This highlights the need for tailored RT treatment, including online-adaptive RT, to manage intra- and interfraction variations. Rectal motion should be handled differently for patients with prostate cancer and those with rectal cancer.http://www.sciencedirect.com/science/article/pii/S2405632424000441Rectum motionPelvic radiotherapyMotion management |
| spellingShingle | Julien Pierrard Sofie Heylen Ad Vandermeulen Geneviève Van Ooteghem Dealing with rectum motion during radiotherapy: How can we anticipate it? Technical Innovations & Patient Support in Radiation Oncology Rectum motion Pelvic radiotherapy Motion management |
| title | Dealing with rectum motion during radiotherapy: How can we anticipate it? |
| title_full | Dealing with rectum motion during radiotherapy: How can we anticipate it? |
| title_fullStr | Dealing with rectum motion during radiotherapy: How can we anticipate it? |
| title_full_unstemmed | Dealing with rectum motion during radiotherapy: How can we anticipate it? |
| title_short | Dealing with rectum motion during radiotherapy: How can we anticipate it? |
| title_sort | dealing with rectum motion during radiotherapy how can we anticipate it |
| topic | Rectum motion Pelvic radiotherapy Motion management |
| url | http://www.sciencedirect.com/science/article/pii/S2405632424000441 |
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