Bladder cancer radiotherapy margins: a comparison of daily alignment using skin, bone or soft tissue

Clin Oncol (R Coll Radiol). 2012 Dec;24(10):673-81. doi: 10.1016/j.clon.2012.06.012. Epub 2012 Jul 31.

Abstract

Aims: To determine the clinical target volume (CTV) to planning target volume (PTV) margins required for bladder coverage when using skin or bony or soft tissue matching on a daily basis.

Materials and methods: Twenty-seven patients with T2-T4 transitional cell carcinoma of the bladder were treated with daily online adaptive image-guided radiotherapy using cone beam computed tomography. All daily CTVs were contoured by a single observer. A retrospective comparison of coverage of the bladder CTV using skin, bone and soft tissue matching was conducted.

Results: With the skin set-up, bladder CTV coverage with a margin of 0.5, 1.0, 1.5, 2.0 and 2.5 cm was 0, 19, 56, 93 and 96%, respectively. For the daily set-up based on bone, the respective coverage was 0, 41, 63, 89 and 96%. For soft tissue set-up based on the geometric centre of the bladder, coverage was 52, 89, 96, 100 and 100%, respectively.

Conclusions: Based on coverage of the CTV, the required CTV to PTV margins are smaller for the daily online soft tissue set-up compared with skin or bone.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bone and Bones / anatomy & histology
  • Cone-Beam Computed Tomography
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Radiotherapy, Image-Guided
  • Retrospective Studies
  • Skin / anatomy & histology
  • Treatment Outcome
  • Urinary Bladder / pathology
  • Urinary Bladder / radiation effects
  • Urinary Bladder Neoplasms / radiotherapy*