Mariana Caffaro

Publications (3)13.48 Total impact

• Article: Spacer stability and prostate position variability during radiotherapy for prostate cancer applying a hydrogel to protect the rectal wall.

  Michael Pinkawa, Marc D Piroth, Richard Holy, Nuria Escobar-Corral, Mariana Caffaro, Victoria Djukic, Jens Klotz, Michael J Eble
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  ABSTRACT: BACKGROUND AND PURPOSE: The aim was to evaluate the spacer dimensions and prostate position variability during the course of radiotherapy for prostate cancer. MATERIALS AND METHODS: CT scans were performed in a group of 15 patients (G1) after the 10ml injection of a hydrogel spacer (SpaceOAR™) and 30 patients without a spacer (G2) before the beginning of treatment (CT1) and in the last treatment week, 10-12weeks following spacer implantation (CT2). Spacer dimensions and displacements were determined and prostate displacements compared. RESULTS: Mean volume of the hydrogel increased slightly (17%; p<0.01), in 4 of 15 patients >2cm(3). The average displacement of the hydrogel center of mass was 0.6mm (87%⩽2.2mm), -0.6mm (100%⩽2.2mm) and 1.4mm (87%⩽4.3mm) in the x-, y- and z-axes (not significant). The average distance between prostate and anterior rectal wall before/at the end of radiotherapy was 1.6cm/1.5cm, 1.2cm/1.3cm and 1.0cm/1.1cm at the level of the base, middle and apex (G1). Prostate position variations were similar comparing G1 and G2, but significant systematic posterior displacements were only found in G2. CONCLUSIONS: A stable distance between the prostate and anterior rectal wall results during the radiotherapy course after injection of the spacer before treatment planning. Larger posterior prostate displacements could be reduced.
  Radiotherapy and Oncology 01/2013; · 5.58 Impact Factor
• Source

  Available from: Nuria Escobar-Corral

  Article: Dose-escalation using intensity-modulated radiotherapy for prostate cancer - evaluation of quality of life with and without (18)F-choline PET-CT detected simultaneous integrated boost.

  Michael Pinkawa, Marc D Piroth, Richard Holy, Jens Klotz, Victoria Djukic, Nuria Escobar Corral, Mariana Caffaro, Oliver H Winz, Thomas Krohn, Felix M Mottaghy, Michael J Eble
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  ABSTRACT: In comparison to the conventional whole-prostate dose escalation, an integrated boost to the macroscopic malignant lesion might potentially improve tumor control rates without increasing toxicity. Quality of life after radiotherapy (RT) with vs. without (18)F-choline PET-CT detected simultaneous integrated boost (SIB) was prospectively evaluated in this study. Whole body image acquisition in supine patient position followed 1 h after injection of 178-355MBq (18)F-choline. SIB was defined by a tumor-to-background uptake value ratio > 2 (GTV(PET)). A dose of 76Gy was prescribed to the prostate (PTV(prostate)) in 2Gy fractions, with or without SIB up to 80Gy. Patients treated with (n = 46) vs. without (n = 21) SIB were surveyed prospectively before (A), at the last day of RT (B) and a median time of two (C) and 19 month (D) after RT to compare QoL changes applying a validated questionnaire (EPIC - expanded prostate cancer index composite). With a median cut-off standard uptake value (SUV) of 3, a median GTV(PET) of 4.0 cm(3) and PTV(boost) (GTV(PET) with margins) of 17.3 cm(3) was defined. No significant differences were found for patients treated with vs. without SIB regarding urinary and bowel QoL changes at times B, C and D (mean differences ≤3 points for all comparisons). Significantly decreasing acute urinary and bowel score changes (mean changes > 5 points in comparison to baseline level at time A) were found for patients with and without SIB. However, long-term urinary and bowel QoL (time D) did not differ relative to baseline levels - with mean urinary and bowel function score changes < 3 points in both groups (median changes = 0 points). Only sexual function scores decreased significantly (> 5 points) at time D. Treatment planning with (18)F-choline PET-CT allows a dose escalation to a macroscopic intraprostatic lesion without significantly increasing toxicity.
  Radiation Oncology 01/2012; 7:14. · 2.32 Impact Factor
• Article: Application of a spacer gel to optimize three-dimensional conformal and intensity modulated radiotherapy for prostate cancer.

  Michael Pinkawa, Nuria Escobar Corral, Mariana Caffaro, Marc D Piroth, Richard Holy, Victoria Djukic, Gundula Otto, Felix Schoth, Michael J Eble
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  ABSTRACT: The aim was to evaluate the impact of a spacer gel on the dose distribution, applying three-dimensional conformal (3D CRT) and intensity modulated radiotherapy (IMRT) planning techniques. The injection of a spacer gel (10 ml SpaceOAR™) was performed between the prostate and rectum under transrectal ultrasound guidance in 18 patients with prostate cancer. 3D CRT and IMRT treatment plans were compared based on CT before and after injection (78 Gy prescription dose). In contrast to the PTV and bladder, significant advantages (p<0.01) resulted in respect of all analysed rectal dose values comparing pre spacer with post spacer plans for both techniques. Rectal NTCP (normal tissue complication probability) reached the lowest percentage after spacer injection irrespective of the technique, with a mean reduction of >50% for both IMRT and 3D CRT. Significantly (p<0.01) higher D(mean), and V(78) for the PTV were reached with IMRT vs. 3D CRT plans, with a smaller rectum V(76) but larger rectum V(50). The injection of a spacer gel between the prostate and anterior rectal wall is associated with considerably lower doses to the rectum and consequentially lower NTCP values irrespective of the radiotherapy technique.
  Radiotherapy and Oncology 09/2011; 100(3):436-41. · 5.58 Impact Factor