Abstract
Backgrounds
Prostate motion and rectal sparing are important treatment strategy issues in external-beam radiotherapy for localized prostate cancer. To address these issues, we prospectively investigated the feasibility of using a double-balloon rectal catheter.
Methods
The rectal catheter has inner and outer balloons that wedge the anus between them. Computed tomography (CT) examinations with and without the catheter were conducted in seven patients with localized prostate cancer treated by external-beam radiotherapy. The rectal wall sparing effect was evaluated using virtual three-dimensional conformal radiotherapy plans in each arm. To evaluate interfractional prostate motion, each patient underwent a series of four CT examinations consisting of a planning CT followed by three additional series of CT with and without a catheter during the course of radiotherapy.
Results
Virtual plans demonstrated the reduction of the dose to the rectum by expanding the posterior wall to lie outside the high- to intermediate-dose area when a catheter was applied. Interfractional prostate motion in the anteroposterior direction was effectively reduced by catheter usage; the mean ± standard deviation (SD) of the displacement was 1.3 ± 0.9 mm with a catheter as compared to 2.8 ± 1.8 mm without a catheter (P = 0.014), and the maximum displacement was successfully suppressed to 3 mm with a catheter compared to 6 mm without a catheter. Systematic and random components were also reduced with the catheter.
Conclusion
These results suggest the feasibility and clinical applicability of the double-balloon rectal catheter.
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Acknowledgments
This work was partially supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology (20229009) of Japan, and Grants-in-Aid for Scientific Research on Priority Areas (Cancer) from the Ministry of Education, Culture, Sports, Science, and Technology (17016036) of Japan. These study sponsors played no role in the study design, the collection, analysis and interpretation of data, the writing of this manuscript, or the decision to submit this manuscript for publication.
Conflict of interest
None of the authors have any financial relationship with any commercial entity that has an interest in the subject matter or materials discussed in this manuscript.
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Takayama, K., Mizowaki, T., Negoro, Y. et al. Impact of double-balloon rectal catheter use in external-beam radiotherapy for prostate cancer. Int J Clin Oncol 16, 50–56 (2011). https://doi.org/10.1007/s10147-010-0129-7
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DOI: https://doi.org/10.1007/s10147-010-0129-7