The effect of incidental dose to pelvic nodes in bladder-only irradiation in the era of IMRT: a dosimetric study.
Strahlenther Onkol
; 2024 Jun 18.
Article
en En
| MEDLINE
| ID: mdl-38888741
ABSTRACT
PURPOSE:
While three-dimensional radiotherapy (RT) causes high incidental nodal doses in bladder-only irradiation for muscle-invasive bladder cancer (MIBC), the impact on pelvic lymphatics is unclear in the era of intensity-modulated RT (IMRT). This study evaluates incidental doses to pelvic lymphatics in MIBC patients treated with IMRT.METHODS:
The data of 40 MIBC patients treated with bladder-only IMRT and concurrent chemotherapy were retrospectively evaluated. The pelvic lymphatics were contoured on initial simulation images and incidental nodal doses were evaluated. The Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, NY, USA) was used for statistics.RESULTS:
Median RT dose to the bladder was 60â¯Gy in 30 fractions. In dosimetric analysis, median values of mean dose (Dmean) of the obturator, presacral, external iliac, internal iliac, and distal common iliac lymphatics were 33â¯Gy (range 4-50â¯Gy), 3â¯Gy (range 1-28â¯Gy), 9.5â¯Gy (range 3-41â¯Gy), 7.5â¯Gy (range 2-14â¯Gy), and 1â¯Gy (range 0-15â¯Gy), respectively. The Dmean of the obturator lymphatics was significantly higher (pâ¯< 0.001) and the Dmean of the distal common iliac lymphatics was significantly lower (pâ¯< 0.001) than all remaining lymphatic stations. The Dmean of the external iliac lymphatics was significantly higher than that of the presacral lymphatics (pâ¯< 0.001), but the difference with the internal iliac lymphatics was not statistically significant (pâ¯= 0.563).CONCLUSION:
The incidental nodal doses with bladder-only IMRT are heterogeneous and remain below the generally accepted doses for microscopic disease eradication for bladder cancer.
Texto completo:
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Banco de datos:
MEDLINE
Idioma:
En
Revista:
Strahlenther Onkol
/
Strahlenther. Onkol
/
Strahlentherapie und Onkologie
Asunto de la revista:
NEOPLASIAS
/
RADIOTERAPIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Turquía