Adaptive magnetic resonance-guided neurovascular-sparing radiotherapy for preservation of erectile function in prostate cancer patients
| العنوان: | Adaptive magnetic resonance-guided neurovascular-sparing radiotherapy for preservation of erectile function in prostate cancer patients |
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| المؤلفون: | J. Hes, Eline N. de Groot-van Breugel, Jochem R.N. van der Voort van Zyp, Johannes C J de Boer, T. Willigenburg, Ruud C. Wortel, Helena M. Verkooijen, Frederik R. Teunissen, Harm H.E. van Melick |
| المصدر: | Physics and Imaging in Radiation Oncology Physics and Imaging in Radiation Oncology, Vol 20, Iss, Pp 5-10 (2021) |
| بيانات النشر: | Elsevier BV, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, medicine.medical_treatment, R895-920, Erectile function sparing, Medical physics. Medical radiology. Nuclear medicine, Prostate cancer, Prostate, medicine.artery, medicine, Erectile dysfunction, Radiology, Nuclear Medicine and imaging, Original Research Article, Internal pudendal artery, Adverse effect, RC254-282, Localized prostate cancer, MR-Linac, Radiation, integumentary system, medicine.diagnostic_test, business.industry, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, MRgRT, Magnetic resonance imaging, equipment and supplies, Neurovascular bundle, medicine.disease, Radiation therapy, medicine.anatomical_structure, nervous system, Neurovascular-sparing, Radiology, business, human activities, circulatory and respiratory physiology |
| الوصف: | Highlights • Magnetic resonance-guided radiotherapy enables visualization and dose adaptation of neurovascular structures. • Neurovascular-sparing magnetic resonance-guided radiotherapy hypothetically preserves erectile function. • Neurovascular-sparing 5×7.25 Gy magnetic resonance-guided radiotherapy for localized prostate cancer is feasible. • Extent of neurovascular bundle sparing largely depends on tumor location. Background and purpose Erectile dysfunction is a common adverse effect of external beam radiation therapy for localized prostate cancer (PCa), likely as a result of damage to neural and vascular tissue. Magnetic resonance-guided online adaptive radiotherapy (MRgRT) enables high-resolution MR imaging and paves the way for neurovascular-sparing approaches, potentially lowering erectile dysfunction after radiotherapy for PCa. The aim of this study was to assess the planning feasibility of neurovascular-sparing MRgRT for localized PCa. Materials and methods Twenty consecutive localized PCa patients, treated with standard 5×7.25 Gy MRgRT, were included. For these patients, neurovascular-sparing 5×7.25 Gy MRgRT plans were generated. Dose constraints for the neurovascular bundle (NVB), the internal pudendal artery (IPA), the corpus cavernosum (CC), and the penile bulb (PB) were established. Doses to regions of interest were compared between the neurovascular-sparing plans and the standard clinical pre-treatment plans. Results Neurovascular-sparing constraints for the CC, and PB were met in all 20 patients. For the IPA, constraints were met in 19 (95%) patients bilaterally and 1 (5%) patient unilaterally. Constraints for the NVB were met in 8 (40%) patients bilaterally, in 8 (40%) patients unilaterally, and were not met in 4 (20%) patients. NVB constraints were not met when gross tumor volume (GTV) was located dorsolaterally in the prostate. Dose to the NVB, IPA, and CC was significantly lower in the neurovascular-sparing plans. Conclusions Neurovascular-sparing MRgRT for localized PCa is feasible in the planning setting. The extent of NVB sparing largely depends on the patient’s GTV location in relation to the NVB. |
| تدمد: | 2405-6316 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1c01c399cce1433f8f1b19b7456a4205 https://doi.org/10.1016/j.phro.2021.09.002 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....1c01c399cce1433f8f1b19b7456a4205 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 24056316 |
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