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The impact of androgen deprivation therapy on setup errors during external beam radiation therapy for prostate cancer

Einfluss der Androgendeprivationstherapie auf Konfigurationsfehler bei der externen Strahlentherapie des Prostatakarzinoms

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Abstract

Purpose

To determine whether setup errors during external beam radiation therapy (RT) for prostate cancer are influenced by the combination of androgen deprivation treatment (ADT) and RT.

Materials and methods

Data from 175 patients treated for prostate cancer were retrospectively analyzed. Treatment was as follows: concurrent ADT plus RT, 33 patients (19%); neoadjuvant and concurrent ADT plus RT, 91 patients (52%); RT only, 51 patients (29%). Required couch shifts without rotations were recorded for each megavoltage (MV) cone beam computed tomography (CBCT) scan, and corresponding alignment shifts were recorded as left–right (x), superior–inferior (y), and anterior–posterior (z). The nonparametric Mann–Whitney test was used to compare shifts by group. Pearson’s correlation coefficient was used to measure the correlation of couch shifts between groups. Mean prostate shifts and standard deviations (SD) were calculated and pooled to obtain mean or group systematic error (M), SD of systematic error (Σ), and SD of random error (σ).

Results

No significant differences were observed in prostate shifts in any direction between the groups. Shifts on CBCT were all less than setup margins. A significant positive correlation was observed between prostate volume and the z‑direction prostate shift (r = 0.19, p = 0.04), regardless of ADT group, but not between volume and x‑ or y‑direction shifts (r = 0.04, p = 0.7; r = 0.03, p = 0.7). Random and systematic errors for all patient cohorts and ADT groups were similar.

Conclusion

Hormone therapy given concurrently with RT was not found to significantly impact setup errors. Prostate volume was significantly correlated with shifts in the anterior–posterior direction only.

Zusammenfassung

Ziel

Ziel war zu untersuchen, ob Konfigurationsfehler bei der externen Radiotherapie (RT) des Prostatakarzinoms durch die Kombination aus Androgendeprivationstherapie (ADT) und RT beeinflusst werden.

Material und Methoden

Retrospektiv wurden die Daten von 175 wegen eines Prostatakarzinoms behandelten Patienten ausgewertet. Die Therapie erfolgte als gleichzeitige ADT plus RT, 33 Patienten (19%); neoadjuvante und gleichzeitige ADT plus RT, 91 Patienten (52%); RT allein, 51 Patienten (29%). Die erforderlichen Verschiebungen der Patientenliege ohne Rotation wurden für jede Megavolt-Cone-Beam-Computertomographie(MV-CBCT)-Aufnahme dokumentiert und die entsprechenden Verschiebungen im Rahmen der Ausrichtung erfasst als links–rechts (x), superior–inferior (y) und anterior–posterior (z). Um die Verschiebungen pro Gruppe zu vergleichen, wurde der nichtparametrische Mann-Whitney-Test eingesetzt. Der Korrelationskoeffizient nach Pearson diente dazu, die Korrelation der Verschiebungen der Patientenliege zwischen den Gruppen zu ermitteln. Die mittleren Verschiebungen der Prostata und Standardabweichungen („standard deviations“, SD) wurden berechnet und zusammengefasst, um den mittleren bzw. gruppenbezogenen systematischen Fehler (M) zu erhalten, die SD des systematischen Fehlers (Σ) und die SD des Zufallsfehlers (σ).

Ergebnisse

Es wurden keine signifikanten Unterschiede bei den Prostataverschiebungen jeglicher Richtung für alle Gruppen festgestellt. Die Verschiebungen in der CBCT waren alle geringer als die Konfigurationsgrenzwerte. Eine signifikante positive Korrelation wurde zwar, unabhängig von der ADT-Gruppe, zwischen dem Prostatavolumen und der Prostataverschiebung in z‑Richtung beobachtet (r = 0,19; p = 0,04), nicht aber zwischen dem Volumen der Verschiebung in x‑ oder y‑Richtung (r = 0,04; p = 0,7; r = 0,03; p = 0,7). Zufalls- und systematischer Fehler für alle Patientenkohorten und ADT-Gruppen waren ähnlich.

Schlussfolgerung

Für die gleichzeitige Therapie mit Hormonen und RT wurde kein signifikanter Einfluss auf Konfigurationsfehler festgestellt. Das Prostatavolumen war nur signifikant mit Verschiebungen in Richtung anterior–posterior korreliert.

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Authors and Affiliations

  1. Faculty of Medicine, Adana Dr. Turgut Noyan Research and Treatment Centre, Department of Radiation Oncology, Baskent University, 01120, Adana, Turkey

    Cem Onal MD, Yemliha Dolek MSci & Yurday Ozdemir MD

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  1. Cem Onal MD
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  2. Yemliha Dolek MSci
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  3. Yurday Ozdemir MD
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Correspondence to Cem Onal MD.

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C. Onal, Y. Dolek, and Y. Ozdemir declare that they have no competing interests.

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Onal, C., Dolek, Y. & Ozdemir, Y. The impact of androgen deprivation therapy on setup errors during external beam radiation therapy for prostate cancer. Strahlenther Onkol 193, 472–482 (2017). https://doi.org/10.1007/s00066-017-1131-z

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  • DOI: https://doi.org/10.1007/s00066-017-1131-z

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