Onal Cem, Dolek Yemliha, Ozdemir Yurday
Faculty of Medicine, Adana Dr. Turgut Noyan Research and Treatment Centre, Department of Radiation Oncology, Baskent University, 01120, Adana, Turkey.
Strahlenther Onkol. 2017 Jun;193(6):472-482. doi: 10.1007/s00066-017-1131-z. Epub 2017 Apr 13.
To determine whether setup errors during external beam radiation therapy (RT) for prostate cancer are influenced by the combination of androgen deprivation treatment (ADT) and RT.
Data from 175 patients treated for prostate cancer were retrospectively analyzed. Treatment was as follows: concurrent ADT plus RT, 33 patients (19%); neoadjuvant and concurrent ADT plus RT, 91 patients (52%); RT only, 51 patients (29%). Required couch shifts without rotations were recorded for each megavoltage (MV) cone beam computed tomography (CBCT) scan, and corresponding alignment shifts were recorded as left-right (x), superior-inferior (y), and anterior-posterior (z). The nonparametric Mann-Whitney test was used to compare shifts by group. Pearson's correlation coefficient was used to measure the correlation of couch shifts between groups. Mean prostate shifts and standard deviations (SD) were calculated and pooled to obtain mean or group systematic error (M), SD of systematic error (Σ), and SD of random error (σ).
No significant differences were observed in prostate shifts in any direction between the groups. Shifts on CBCT were all less than setup margins. A significant positive correlation was observed between prostate volume and the z‑direction prostate shift (r = 0.19, p = 0.04), regardless of ADT group, but not between volume and x‑ or y‑direction shifts (r = 0.04, p = 0.7; r = 0.03, p = 0.7). Random and systematic errors for all patient cohorts and ADT groups were similar.
Hormone therapy given concurrently with RT was not found to significantly impact setup errors. Prostate volume was significantly correlated with shifts in the anterior-posterior direction only.
确定前列腺癌外照射放疗（RT）期间的摆位误差是否受雄激素剥夺治疗（ADT）与RT联合应用的影响。
对175例接受前列腺癌治疗的患者数据进行回顾性分析。治疗方式如下：同步ADT加RT，33例患者（19%）；新辅助和同步ADT加RT，91例患者（52%）；单纯RT，51例患者（29%）。记录每次兆伏（MV）锥形束计算机断层扫描（CBCT）时所需的无旋转治疗床移位情况，并将相应的对准移位记录为左右（x）、上下（y）和前后（z）方向。采用非参数曼-惠特尼检验比较组间移位情况。使用皮尔逊相关系数测量组间治疗床移位的相关性。计算并汇总平均前列腺移位及标准差（SD），以获得平均或组系统误差（M）、系统误差标准差（Σ）和随机误差标准差（σ）。
各治疗组间在任何方向上的前列腺移位均未观察到显著差异。CBCT上的移位均小于摆位边界。无论ADT组如何，前列腺体积与z方向前列腺移位之间均观察到显著正相关（r = 0.19，p = 0.04），但体积与x或y方向移位之间无相关性（r = 0.04，p = 0.7；r = 0.03，p = 0.7）。所有患者队列和ADT组的随机误差和系统误差相似。
未发现同步进行的激素治疗对摆位误差有显著影响。仅前列腺体积与前后方向的移位显著相关。
