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Prostate Cancer
Volume 2012 (2012), Article ID 130579, 6 pages
http://dx.doi.org/10.1155/2012/130579
Research Article

Prostate Intrafraction Translation Margins for Real-Time Monitoring and Correction Strategies

1Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI 48109-5010, USA
2M. D. Anderson Cancer Center Orlando, Orlando, FL 32806, USA
3UCLA, Los Angeles, CA 90095, USA
4Cleveland Clinic Foundation, Cleveland, OH 44195, USA
5Sharp Health Care Hospital, San Diego, CA 92123, USA
6University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
7Nebraska Medical Center, Omaha, NE 68198, USA
8Calypso Medical Technologies Inc., Seattle, WA 98121, USA
9Cedars-Sinai, Los Angeles, CA 90048, USA

Received 25 January 2011; Accepted 12 May 2011

Academic Editor: May Abdel-Wahab

Copyright © 2012 Dale W. Litzenberg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this work is to determine appropriate radiation therapy beam margins to account for intrafraction prostate translations for use with real-time electromagnetic position monitoring and correction strategies. Motion was measured continuously in 35 patients over 1157 fractions at 5 institutions. This data was studied using van Herk's formula of (αΣ+γσ') for situations ranging from no electromagnetic guidance to automated real-time corrections. Without electromagnetic guidance, margins of over 10 mm are necessary to ensure 95% dosimetric coverage while automated electromagnetic guidance allows the margins necessary for intrafraction translations to be reduced to submillimeter levels. Factors such as prostate deformation and rotation, which are not included in this analysis, will become the dominant concerns as margins are reduced. Continuous electromagnetic monitoring and automated correction have the potential to reduce prostate margins to 2-3 mm, while ensuring that a higher percentage of patients (99% versus 90%) receive a greater percentage (99% versus 95%) of the prescription dose.