Surgery (Austin & Northern Health) - Research Publications

Permanent URI for this collection

http://hdl.handle.net/11343/187

Filters

2018 - 2019 2
Reset filters

Settings
Statistics
Citations
Author: Bolton, Damien × Author: Chao, Michael × Author: Sengupta, Shomik × End date: 2019 × Start date: 2011 × Type: Journal Article ×

Search Results

Now showing 1 - 2 of 2
  • Item
    Thumbnail Image
    Prospective analysis of hydrogel spacer for patients with prostate cancer undergoing radiotherapy
    Chao, M ; Ho, H ; Chan, Y ; Tan, A ; Trung, P ; Bolton, D ; Troy, A ; Temelcos, C ; Sengupta, S ; McMillan, K ; Cham, CW ; Liu, M ; Ding, W ; Subramanian, B ; Wasiak, J ; Joon, DL ; Spencer, S ; Lawrentschuk, N (WILEY, 2018-09)
    OBJECTIVE: To report on the dosimetric benefits and late toxicity outcomes after injection of hydrogel spacer (HS) between the prostate and rectum for patients treated with prostate radiotherapy (RT). PATIENTS AND METHODS: In all, 76 patients with a clinical stage of T1-T3a prostate cancer underwent general anaesthesia for fiducial marker insertion plus injection of the HS into the perirectal space before intensity-modulated RT (IMRT) or volumetric-modulated arc RT (VMAT). HS safety, dosimetric benefits, and the immediate- to long-term effects of gastrointestinal (GI) toxicity were assessed. RESULTS: There were no postoperative complications reported. The mean (range) prostate size was 66.0 (25.0-187.0) mm. Rectal dose volume parameters were observed and the volume of rectum receiving 70 Gy (rV70 ), 75 Gy (rV75 ) and 78 Gy (rV78 ) was 7.8%, 3.6% and 0.4%, respectively. In all, 21% of patients (16/76) developed acute Grade 1 GI toxicities, but all were resolved completely by 3 months after treatment; whilst, 3% of patients (2/76) developed late Grade 1 GI toxicities. No patients had acute or late Grade ≥2 GI toxicities. CONCLUSION: Injection of HS resulted in a reduction of irradiated rectal dose volumes along with minimal GI toxicities, irrespective of prostate size.
  • Item
    Thumbnail Image
    The use of tissue fiducial markers in improving the accuracy of post-prostatectomy radiotherapy
    Chao, M ; Ho, H ; Joon, DU ; Chan, Y ; Spencer, S ; Ng, M ; Wasiak, J ; Lawrentschuk, N ; McMillan, K ; Sengupta, S ; Tan, A ; Koufogiannis, G ; Cokelek, M ; Foroudi, F ; Khong, T-S ; Bolton, D (KOREAN SOC THERAPEUTIC RADIOLOGY & ONCOLOGY, 2019-03)
    PURPOSE: The aim of this retrospective study was to investigate the use of a radiopaque tissue fiducial marker (TFM) in the treatment of prostate cancer patients who undergo post-prostatectomy radiotherapy (PPRT). TFM safety, its role and benefit in quantifying the set-up uncertainties in patients undergoing PPRT image-guided radiotherapy were assessed. MATERIALS AND METHODS: A total of 45 consecutive PPRT patients underwent transperineal implantation of TFM at the level of vesicourethral anastomosis in the retrovesical tissue prior to intensity-modulated radiotherapy. Prostate bed motion was calculated by measuring the position of the TFM relative to the pelvic bony anatomy on daily cone-beam computed tomography. The stability and visibility of the TFM were assessed in the initial 10 patients. RESULTS: No postoperative complications were recorded. A total of 3,500 images were analysed. The calculated prostate bed motion for bony landmark matching relative to TFM were 2.25 mm in the left-right, 5.89 mm in the superior-inferior, and 6.59 mm in the anterior-posterior directions. A significant 36% reduction in the mean volume of rectum receiving 70 Gy (rV70) was achieved for a uniform planning target volume (PTV) margin of 7 mm compared with the Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recommended PTV margin of 10 mm. CONCLUSION: The use of TFM was safe and can potentially eliminate set-up errors associated with bony landmark matching, thereby allowing for tighter PTV margins and a consequent favourable reduction in dose delivered to the bladder and rectum, with potential improvements in toxicities.