Qi Xin,Gao Xianshu,Li Feiyu,Zhang Min,Li Hongzhen,Li Xiaomei,Wang Qingguo,Qin Shangbin,Ma Mingwei,Wang Xiaoying,Wang Dian.The optimal clinical target volume for the seminal vesicle in localized prostate cancer radiotherapy[J].Chinese Journal of Radiological Medicine and Protection,2014,34(7):518-522
The optimal clinical target volume for the seminal vesicle in localized prostate cancer radiotherapy
Received:March 10, 2014  
DOI:10.3760/cma.j.issn.0254-5098.2014.07.010
KeyWords:Prostate cancer  Radiotherapy  Seminal vesicle  Target delineation  CT reconstruction
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Author NameAffiliationE-mail
Qi Xin Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Gao Xianshu Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China gao7777@139.com 
Li Feiyu Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Zhang Min Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Li Hongzhen Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Li Xiaomei Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Wang Qingguo Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Qin Shangbin Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Ma Mingwei Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Wang Xiaoying Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China  
Wang Dian Department of Radiation Oncology, Rush University Medical Center  
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Abstract::
      Objective To discuss the clinical target volume (CTV) for the seminal vesicle (SV) in localized prostate cancer radiotherapy.Methods Radiotherapy planning CT images from 114 patients with intermediate- or high-risk prostate cancer were collected and reconstructed at a thickness of 1 mm. Cross sections of the SV, 1.0 and 2.0 cm from the starting point, were located. Then, the maximum (D10H, D20H) and minimum (D10L, D20L) distance from these two cross sections to the initial plane of the SV were measured the proximal SV included in the high-dose CTV based on EORTC prostate cancer radiotherapy guideline and the current RTOG 0815 protocol guideline and the anatomic volume of proximal 1 and 2 cm SV were compared. Results The distance of D10H, D10L, D20H and D20L were (10.6 ± 1.8), (2.1 ± 2.0), (17.2 ± 2.9) and (8.8 ± 2.7)mm, D10H and D20H that can include 95% of the patients were 13.5 mm and 21.4 mm respectively. A smaller SV tilt angle (α and β) and a larger diameter of the cross section (R10/20) were associated with a longer D10H (R2=0.64, P<0.01) or D20H (R2=0.77, P<0.01). When it was defined 1.0 cm vertically upward from the initial plane as the upper limit of the CTV, the proximal 1.0 cm of the SV could not been entirely encompassed in 65.8%(75/114) of the enrolled cases. The proximal 2.0 cm of the SV could not been entirely encompassed in 17.5%(20/114) of our cases when 2.0 cm as the upper limit were used. Conclusions In order to contouring anatomic 1.0 cm/2.0 cm SV, the high-dose CTV need to extend 1.4 cm/2.2 cm upward for the anteromedial portion of the SV, and 0.5 cm/1.4 cm for the posterolateral SV.
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