Optimal contouring of seminal vesicle for definitive radiotherapy of localized prostate cancer: comparison between EORTC prostate cancer radiotherapy guideline, RTOG0815 protocol and actual anatomy

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• 作者：Xin Qi (1)
  Xian-Shu Gao (1)
  Junichi Asaumi (2)
  Min Zhang (1)
  Hong-Zhen Li (1)
  Ming-Wei Ma (1)
  Bo Zhao (1)
  Fei-Yu Li (3)
  Dian Wang (4)
  
  1. Department of Radiation Oncology ; Peking University First Hospital ; Beijing ; China
  2. Department of Oral and Maxillofacial Radiology ; Field of Tumor Biology ; Okayama University Graduate School of Medicine ; Dentistry and Pharmaceutical Sciences ; Okayama ; Japan
  3. Department of Radiology ; Peking University First Hospital ; Beijing ; China
  4. Department of Radiation Oncology ; Rush University Medical Center ; Chicago ; IL ; USA
  
• 关键词：Prostate cancer ; Radiotherapy ; Seminal vesicle ; Target delineation ; CT reconstruction
• 刊名：Radiation Oncology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：9
• 期：1
• 全文大小：1,294 KB
• 参考文献：1. Eifler, JB, Feng, Z, Lin, BM, Partin, MT, Humphreys, EB, Han, M, Epstein, JI, Walsh, PC, Trock, BJ, Partin, AW (2013) An updated prostate cancer staging nomogram (Partin tables) based on cases from 2006 to 2011. BJU Int 111: pp. 22-29 CrossRef
  2. Katcher, J, Kupelian, PA, Zippe, C, Klein, EA, Sohn, JW (1997) Indications for excluding the seminal vesicles when treating clinically localized prostatic adenocarcinoma with radiotherapy alone. Int J Radiat Oncol Biol Phys 37: pp. 871-876 CrossRef
  3. D'amico, AV, Whittington, R, Kaplan, I, Beard, C, Schultz, D, Malkowicz, SB, Tomaszewski, JE, Wein, A, Coleman, CN (1997) Equivalent 5-year bNED in select prostate cancer patients managed with surgery or radiation therapy despite exclusion of the seminal vesicles from the CTV. Int J Radiat Oncol Biol Phys 39: pp. 335-340 CrossRef
  4. Zlotta, AR, Roumegu猫re, T, Ravery, V, Hoffmann, P, Montorsi, F, T眉rkeri, L, Dobrovrits, M, Scattoni, V, Ekane, S, Bollens, R (2004) Is seminal vesicle ablation mandatory for all patients undergoing radical prostatectomy? A multivariate analysis on 1283 patients. Eur Urol 46: pp. 42-49 CrossRef
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  6. Kestin, L, Goldstein, N, Vicini, F, Yan, D, Korman, H, Martinez, A (2002) Treatment of prostate cancer with radiotherapy: should the entire seminal vesicles be included in the clinical target volume?. Int J Radiat Oncol Biol Phys 54: pp. 686-697 CrossRef
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  9. Boehmer, D, Maingon, P, Poortmans, P, Baron, MH, Miralbell, R, Remouchamps, V, Scrase, C, Bossi, A, Bolla, M (2006) Guidelines for primary radiotherapy of patients with prostate cancer. Radiother Oncol 79: pp. 259-269 CrossRef
  10. Swanson, GP, Goldman, B, Tangen, CM, Chin, J, Messing, E, Canby-Hagino, E, Forman, JD, Thompson, IM, Crawford, ED (2008) The prognostic impact of seminal vesicle involvement found at prostatectomy and the effects of adjuvant radiation: data from Southwest Oncology Group 8794. J Urol 180: pp. 2453-2457 CrossRef
  11. Meeks, JJ, Walker, M, Bernstein, M, Eastham, JA (2013) Seminal vesicle involvement at salvage radical prostatectomy. BJU Int 111: pp. E342-E347 CrossRef
  12. Bayman, NA, Wylie, JP (2007) When should the seminal vesicles be included in the target volume in prostate radiotherapy?. Clin Oncol (R Coll Radiol) 19: pp. 302-307 CrossRef
  
• 刊物主题：Oncology; Radiotherapy;
• 出版者：BioMed Central
• ISSN：1748-717X

文摘

Background Intermediate- to-high-risk prostate cancer can locally invade seminal vesicle (SV). It is recommended that anatomic proximal 1-cm to 2-cm SV be included in the clinical target volume (CTV) for definitive radiotherapy based on pathology studies. However, it remains unclear whether the pathology indicated SV extent is included into the CTV defined by current guidelines. The purpose of this study is to compare the volume of proximal SV included in CTV defined by EORTC prostate cancer radiotherapy guideline and RTOG0815 protocol with the actual anatomic volume. Methods Radiotherapy planning CT images from 114 patients with intermediate- (36.8%) or high-risk (63.2%) prostate cancer were reconstructed with 1-mm-thick sections. The starting and ending points of SV and the cross sections of SV at 1-cm and 2-cm from the starting point were determined using 3D-view. Maximum (D1H, D2H) and minimum (D1L, D2L) vertical distance from these cross sections to the starting point were measured. Then, CTV of proximal SV defined by actual anatomy, EORTC guideline and RTOG0815 protocol were contoured and compared (paired t test). Results Median length of D1H, D1L, D2H and D2L was 10.8 mm, 2.1 mm, 17.6 mm and 8.8 mm (95th percentile: 13.5mm, 5.0mm, 21.5mm and 13.5mm, respectively). For intermediate-risk patients, the proximal 1-cm SV CTV defined by EORTC guideline and RTOG0815 protocol inadequately included the anatomic proximal 1-cm SV in 62.3% (71/114) and 71.0% (81/114) cases, respectively. While for high-risk patients, the proximal 2-cm SV CTV defined by EORTC guideline inadequately included the anatomic proximal 2-cm SV in 17.5% (20/114) cases. Conclusions SV involvement indicated by pathology studies was not completely included in the CTV defined by current guidelines. Delineation of proximal 1.4 cm and 2.2 cm SV in axial plane may be adequate to include the anatomic proximal 1-cm and 2-cm SV. However, part of SV may be over-contoured.