Radiotherapy dose-distribution to the perirectal fat space (PRS) is related to gastrointestinal control-related complications

S L Gulliford; S Ghose; M A Ebert; A Kennedy; J Dowling; J Mitra; D J Joseph; J W Denham

doi:10.1016/j.ctro.2017.10.002

Radiotherapy dose-distribution to the perirectal fat space (PRS) is related to gastrointestinal control-related complications

S L Gulliford, S Ghose, M A Ebert, A Kennedy, J Dowling, J Mitra, D J Joseph, J W Denham

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Abstract

Traditionally rectal symptoms following pelvic/prostate radiotherapy are correlated to the dosimetry of the anorectum or a substructure of this. It has been suggested that the perirectal fat space (PRS) surrounding the rectum may also be relevant. This study considers the delineation and dosimetry of the PRS related to both rectal bleeding and control-related toxicity. Initially, a case-control cohort of 100 patients from the RADAR study were chosen based on presence/absence of rectal control-related toxicity. Automated contouring was developed to delineate the PRS. 79 of the 100 auto-segmentations were considered successful. Balanced case-control cohorts were defined from these cases. Atlas of Complication Incidence (ACI) were generated to relate the DVH of the PRS with specific rectal symptoms; rectal bleeding and control-related symptoms (LENT/SOM). ACI demonstrated that control-related symptoms were related to the dose distribution to the PRS which was confirmed with Wilcoxon rank sum test (p < 0.05). To the authors knowledge this is the first study implicating the dose distribution to the PRS to the incidence of control-related symptoms of rectal toxicity.

Original language	English
Pages (from-to)	62-70
Number of pages	9
Journal	Clinical and translational radiation oncology
Volume	7
DOIs	https://doi.org/10.1016/j.ctro.2017.10.002
Publication status	Published - 1 Dec 2017

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10.1016/j.ctro.2017.10.002

published versionFinal published version, 2.85 MBLicence: CC BY-NC-ND

Assessment of Rectal and Urinary Toxicity from the RADAR Prostate Radiotherapy Trial? Dosimetric Constraints for Novel Symptom Clustering, Derivation of Radiobiological Parameters and Assessment of Patient Localisation Effects
Ebert, M. (Investigator 01), Denham, J. (Investigator 02), Joseph, D. (Investigator 03), Foo, K. (Investigator 04), Haworth, A. (Investigator 05) & Carolan, M. (Investigator 06)
NHMRC National Health and Medical Research Council
1/01/15 → 31/12/15
Project: Research
Radiotherapy treatment for prostate cancer - a change in practice based on direct evidence for targeting and toxicity effects using real outcomes data
Ebert, M. (Investigator 01), Dowling, J. (Investigator 02), Denham, J. (Investigator 03), Joseph, D. (Investigator 04), Gulliford, S. (Investigator 05), Dearnaley, D. (Investigator 06), Haworth, A. (Investigator 07), Holloway, L. (Investigator 08), Kron, T. (Investigator 09) & Greer, P. (Investigator 10)
NHMRC National Health and Medical Research Council
1/01/15 → 31/12/19
Project: Research

Cite this

@article{e0cf115dbf2546b1bfbb1d4ae19ad720,

title = "Radiotherapy dose-distribution to the perirectal fat space (PRS) is related to gastrointestinal control-related complications",

abstract = "Traditionally rectal symptoms following pelvic/prostate radiotherapy are correlated to the dosimetry of the anorectum or a substructure of this. It has been suggested that the perirectal fat space (PRS) surrounding the rectum may also be relevant. This study considers the delineation and dosimetry of the PRS related to both rectal bleeding and control-related toxicity. Initially, a case-control cohort of 100 patients from the RADAR study were chosen based on presence/absence of rectal control-related toxicity. Automated contouring was developed to delineate the PRS. 79 of the 100 auto-segmentations were considered successful. Balanced case-control cohorts were defined from these cases. Atlas of Complication Incidence (ACI) were generated to relate the DVH of the PRS with specific rectal symptoms; rectal bleeding and control-related symptoms (LENT/SOM). ACI demonstrated that control-related symptoms were related to the dose distribution to the PRS which was confirmed with Wilcoxon rank sum test (p < 0.05). To the authors knowledge this is the first study implicating the dose distribution to the PRS to the incidence of control-related symptoms of rectal toxicity.",

author = "Gulliford, {S L} and S Ghose and Ebert, {M A} and A Kennedy and J Dowling and J Mitra and Joseph, {D J} and Denham, {J W}",

year = "2017",

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doi = "10.1016/j.ctro.2017.10.002",

language = "English",

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T1 - Radiotherapy dose-distribution to the perirectal fat space (PRS) is related to gastrointestinal control-related complications

AU - Gulliford, S L

AU - Ghose, S

AU - Ebert, M A

AU - Kennedy, A

AU - Dowling, J

AU - Mitra, J

AU - Joseph, D J

AU - Denham, J W

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Traditionally rectal symptoms following pelvic/prostate radiotherapy are correlated to the dosimetry of the anorectum or a substructure of this. It has been suggested that the perirectal fat space (PRS) surrounding the rectum may also be relevant. This study considers the delineation and dosimetry of the PRS related to both rectal bleeding and control-related toxicity. Initially, a case-control cohort of 100 patients from the RADAR study were chosen based on presence/absence of rectal control-related toxicity. Automated contouring was developed to delineate the PRS. 79 of the 100 auto-segmentations were considered successful. Balanced case-control cohorts were defined from these cases. Atlas of Complication Incidence (ACI) were generated to relate the DVH of the PRS with specific rectal symptoms; rectal bleeding and control-related symptoms (LENT/SOM). ACI demonstrated that control-related symptoms were related to the dose distribution to the PRS which was confirmed with Wilcoxon rank sum test (p < 0.05). To the authors knowledge this is the first study implicating the dose distribution to the PRS to the incidence of control-related symptoms of rectal toxicity.

AB - Traditionally rectal symptoms following pelvic/prostate radiotherapy are correlated to the dosimetry of the anorectum or a substructure of this. It has been suggested that the perirectal fat space (PRS) surrounding the rectum may also be relevant. This study considers the delineation and dosimetry of the PRS related to both rectal bleeding and control-related toxicity. Initially, a case-control cohort of 100 patients from the RADAR study were chosen based on presence/absence of rectal control-related toxicity. Automated contouring was developed to delineate the PRS. 79 of the 100 auto-segmentations were considered successful. Balanced case-control cohorts were defined from these cases. Atlas of Complication Incidence (ACI) were generated to relate the DVH of the PRS with specific rectal symptoms; rectal bleeding and control-related symptoms (LENT/SOM). ACI demonstrated that control-related symptoms were related to the dose distribution to the PRS which was confirmed with Wilcoxon rank sum test (p < 0.05). To the authors knowledge this is the first study implicating the dose distribution to the PRS to the incidence of control-related symptoms of rectal toxicity.

U2 - 10.1016/j.ctro.2017.10.002

DO - 10.1016/j.ctro.2017.10.002

M3 - Article

C2 - 29594231

SN - 2405-6308

VL - 7

SP - 62

EP - 70

JO - Clinical and translational radiation oncology

JF - Clinical and translational radiation oncology

ER -

Radiotherapy dose-distribution to the perirectal fat space (PRS) is related to gastrointestinal control-related complications

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Assessment of Rectal and Urinary Toxicity from the RADAR Prostate Radiotherapy Trial? Dosimetric Constraints for Novel Symptom Clustering, Derivation of Radiobiological Parameters and Assessment of Patient Localisation Effects

Radiotherapy treatment for prostate cancer - a change in practice based on direct evidence for targeting and toxicity effects using real outcomes data

Cite this