title: A practical method to achieve prostate gland immobilization and target verification for daily treatment.
abstract: OBJECTIVE
  A practical method to achieve prostate immobilization and daily target localization for external beam radiation treatment is described.
  
  
  METHODS
  Ten patients who underwent prostate brachytherapy using permanent radioactive source placement were selected for study. To quantify prostate motion both with and without the presence of a specially designed inflatable intrarectal balloon, the computerized tomography-based coordinates of all intraprostatic radioactive sources were compared over 3 consecutive measurements at 1-min intervals.
  
  
  RESULTS
  The placement and inflation of the intrarectal balloon were well tolerated by all patients. The mean (range) displacement of the prostate gland when the intrarectal balloon was present vs. absent was 1.3 (0-2.2) mm vs. 1.8 (0-9.1) mm (p = 0.03) at 2 min respectively. The maximum displacement in any direction (anterior-posterior, superior-inferior, or right-left) when the intrarectal balloon was inflated vs. absent was reduced to < or =1 mm from 4 mm.
  
  
  CONCLUSIONS
  Both prostate gland immobilization and target verification are possible using a specially designed inflatable intrarectal balloon. Using this device, the posterior margin necessary on the lateral fields to ensure dosimetric coverage of the entire prostate gland could be safely reduced to 5 mm and treatment could be set up and verified using a lateral portal image.
authors.affiliation: Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, MA 02115, USA. adamico@jcrt.harvard.edu
authors.forename: A V
authors.initials: AV
authors.lastname: D'Amico
authors.forename: J
authors.initials: J
authors.lastname: Manola
authors.forename: M
authors.initials: M
authors.lastname: Loffredo
authors.forename: L
authors.initials: L
authors.lastname: Lopes
authors.forename: K
authors.initials: K
authors.lastname: Nissen
authors.forename: D A
authors.initials: DA
authors.lastname: O'Farrell
authors.forename: L
authors.initials: L
authors.lastname: Gordon
authors.forename: C M
authors.initials: CM
authors.lastname: Tempany
authors.forename: R A
authors.initials: RA
authors.lastname: Cormack
mesh_terms: D001918:Brachytherapy; D006801:Humans; D007103:Immobilization; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage