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When do you consider replanning patient if body contour is off on CBCT but PTV is aligned to prostate?

Assume SSD at isocenter is correct. When are you concerned about the dose to PTV or OARs? Article below appears to say minor effect. Zhang et al., PMID 33982618
4 Answers
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Radiation Oncology · Michigan Healthcare Professionals, PC
Answered on · Updated on

When reviewing the CBCT for a prostate case, I first look at the PTV. I make adjustments as necessary. Then, I look at the rectum. If anteriorly, it approximates what it looked like at simulation, I proceed with treatment. If it appears substantially off, I may consider having the patient come down ...

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Radiation Oncology · The Ohio State University - James Cancer Hospital and Solove Research Institute
Answered on

Not a GU specialist but we frequently encounter this issue in H&N where body contour changes are more pronounced due to weight loss. If there is any question, run a verification plan using the existing plan with new body contour from CBCT. Dosi can density override such that any contour gain becomes...

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Radiation Oncology · AdventHealth Cancer Institute
Answered on

I agree with Dr. @Dr. First Last. I haven't come across a case yet where I have replanned a prostate cancer patient due to changes in body habitus, but that is because they generally maintain a stable weight. I have done so for a number of other cancer types. I do look when I review each CBCT becaus...

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Radiation Oncology · Good Samaritan Hospital
Answered on

Thank you everyone for your input and expertise. This was the first prostate patient I have had to replan due to body change. The patient started developing covid-like symptoms the day we were to start him. His treatment ended up being delayed and interestingly enough, he decided to get in shape for...

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