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開催概要
開催回
第54回・2016年・横浜
 

An impact of pelvic magnetic resonance imaging to radiotherapy volume definition in patients with intermediate- and high-risk prostate cancer: A Population based study

演題番号 : P25-10

[筆頭演者]
Mermershtain Wilmosh:1 
[共同演者]
Rouvinov Keren:1、Belochitski Olga:1、Keizman Daniel:2、Ariad Samuel:1、Lavrenkov Konstantin:1

1:Soroka University Medical Center, Israel・Department of Oncology・Onco - Urology Service、2:Meir Medical Center・Department of Oncology・Onco - Urology Service

 

Purpose:
This is a retrospective study to evaluate an influence of pelvic MRI (PMRI) to delineation of clinical target volume (CTV) for radiotherapy (RT) of intermediate- and high-risk prostate cancer.
Methods:
Medical records of patients with intermediate and high-risk prostate cancer treated with intensity-modulated RT (IMRT) were examined retrospectively. Risk group was defined using NCCN criteria. PMRI reports were reviewed and risk group was re-defined in regards of T- and N-stage. CTVs for IMRT treatment plans were contoured applying PMRI. Extra-capsular extension (ECE) and seminal vesicles invasion (SVI) were included to high-dose CTV. Regional pelvic lymph nodes (RPLN) considered pathological by PMRI were included to separate CTV to receive RT dose higher than unaffected RPLN stations.
Results:
Between 2009 and 2013, 169 patients with intermediate and high-risk prostate cancer underwent PMRI at around 1 month before commencing IMRT. Initially, 89 patients were affiliated to intermediate-risk and 80 to high-risk group. In general, PTV-changes based on PMRI data required in 61 patients (36%). Thirty seven of 89 intermediate-risk patients (42%) were switched to high-risk group, necessitating irradiation of PLN. ECE and SVI were included to high-dose CTV in 64 (38%) and 29 patients (17%) respectively. PLN were thought pathological in 10 patients (6%), which justified contouring of a separate CTV for dose escalation.

Conclusion:
In our series PMRI-scans had a significant impact on RT target coverage decision in patients with intermediate and high-risk prostate cancer. A true value of this impact should be defined a large scale prospective clinical trial.

キーワード

臓器別:前立腺・男性生殖器

手法別:臨床試験

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