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Abstract
The purpose of this case study is to develop a method to account for the difference
in the daily volumes in the bladder, rectum, and targets in prostate radiotherapy
and to compare the predicted dose to the actual dose to these organs. Five patients,
both prospectively and retrospectively, were selected from 2 different cancer centers,
with a biopsy-confirmed diagnosis of prostate cancer. The patients' planning target
volume (PTV) and organs at risk (OAR) were contoured on the computed tomography (CT)
dataset using either Eclipse or Monaco treatment planning systems (TPSs). Cone-beam
computed tomography (CBCT) scans were collected before each daily treatment and exported
to MIM software for analysis. The automatically generated reports evaluated the organ
volume changes, the actual dose received during a single fraction, and the projected
dose to each organ at the completion of the treatment course via comparative cumulative
dose-volume histograms (DVHs). Volume changes in the bladder and rectum can cause
notable variations in the prescribed dose vs the actual dose received. MIM software
was proven to have utility prospectively by tabulating daily dose and projecting final
doses, potentially aiding physicians in decisions about the boost plans, thus making
offline adaptive radiation therapy (ART) clinically manageable.