Improvement of radiation treatment conditions in postoperative prostate cancer

.........................................................................................................................................3 Background and purpose.............................................................................................................3 Material and methods .................................................................................................................3 Results ........................................................................................................................................3 Conclusion ..................................................................................................................................3 Abbreviations and Acronyms...........................................................................................................4 Acknowledgments...........................................................................................................................4 Introduction ....................................................................................................................................5 Postoperative prostate cancer.....................................................................................................5 Cone Beam Computed Tomography ............................................................................................7 Adaptive radiotherapy .............................................................................................................. 10 Aims ............................................................................................................................................. 11 Theoretical overview..................................................................................................................... 12 Treatment system and exposure parameters ............................................................................ 12 Material and methods ................................................................................................................... 14 Bladder filling protocol .............................................................................................................. 14 Pre-study – Inter-patient bladder filling variation ...................................................................... 14 Reproducibility of the bladder volume for postoperative prostate cancer patients .................... 14 Absorbed dose for 2D kV-imaging ............................................................................................. 15 Absorbed dose for CBCT pelvis scan .......................................................................................... 16 Evaluation of SmartAdapt® deformation algorithm ................................................................... 17 Results and discussion................................................................................................................... 19 Pre-study – Inter-patient bladder filling variation ...................................................................... 19 Reproducibility of the bladder volume for postoperative prostate cancer patients .................... 20 Absorbed dose for 2D kV-imaging ............................................................................................. 22 Absorbed dose for CBCT pelvis scan .......................................................................................... 25 Evaluation of SmartAdapt® deformation algorithm ................................................................... 27 Conclusions and Future work ........................................................................................................ 38 Appendix ...................................................................................................................................... 39 References .................................................................................................................................... 40