Premium
Planning magnetic resonance imaging for prostate cancer intensity‐modulated radiation therapy: Impact on target volumes, radiotherapy dose and androgen deprivation administration
Author(s) -
Horsley Patrick J,
Aherne Noel J,
Edwards Grace V,
Benjamin Linus C,
Wilcox Shea W,
McLachlan Craig S,
Assareh Hassan,
Welshman Richard,
McKay Michael J,
Shakespeare Thomas P
Publication year - 2015
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12266
Subject(s) - medicine , prostate cancer , radiation therapy , magnetic resonance imaging , androgen deprivation therapy , contouring , radiation treatment planning , prostate , radiology , management of prostate cancer , hormonal therapy , cancer , nuclear medicine , engineering drawing , engineering
Aims Magnetic resonance imaging ( MRI ) scans are increasingly utilized for radiotherapy planning to contour the primary tumors of patients undergoing intensity‐modulated radiation therapy ( IMRT ). These scans may also demonstrate cancer extent and may affect the treatment plan. We assessed the impact of planning MRI detection of extracapsular extension, seminal vesicle invasion, or adjacent organ invasion on the staging, target volume delineation, doses, and hormonal therapy of patients with prostate cancer undergoing IMRT . Methods The records of 509 consecutive patients with planning MRI scans being treated with IMRT for prostate cancer between J anuary 2010 and J uly 2012 were retrospectively reviewed. Tumor staging and treatment plans before and after MRI were compared. Results Of the 509 patients, 103 (20%) were upstaged and 44 (9%) were migrated to a higher risk category as a result of findings at MRI . In 94 of 509 patients (18%), the MRI findings altered management. Ninety‐four of 509 patients (18%) had a change to their clinical target volume ( CTV ) or treatment technique, and in 41 of 509 patients (8%) the duration of hormone therapy was changed because of MRI findings. Conclusion The use of radiotherapy planning MRI altered CTV design, dose and/or duration of androgen deprivation in 18% of patients in this large, single institution series of men planned for dose‐escalated prostate IMRT . This has substantial implications for radiotherapy target volumes and doses, as well as duration of androgen deprivation. Further research is required to investigate whether newer MRI techniques can simultaneously fulfill staging and radiotherapy contouring roles.