{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:56:02Z","timestamp":1775019362984,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T00:00:00Z","timestamp":1699747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the impact of reducing Clinical Target Volume (CTV) to Planning Target Volume (PTV) margins on delivered radiation therapy (RT) dose and patient reported quality\u2010of\u2010life (QOL) for patients with localized prostate cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty patients were included in a single institution IRB\u2010approved prospective study. Nine were planned with reduced margins (4\u00a0mm at prostate\/rectum interface, 5\u00a0mm elsewhere), and 11 with standard margins (6\/10\u00a0mm). Cumulative delivered dose was calculated using deformable dose accumulation. Each daily CBCT dataset was deformed to the planning CT (pCT), dose was computed, and accumulated on the resampled pCT using a parameter\u2010optimized, B\u2010spline algorithm (Elastix, ITK\/VTK). EPIC\u201026 patient reported QOL was prospectively collected pre\u2010treatment, post\u2010treatment, and at 2\u2010, 6\u2010, 12\u2010, 18\u2010, 24\u2010, 36\u2010, 48\u2010, and 60\u2010month follow\u2010ups. Post \u2010RT QOL scores were baseline corrected and standardized to a [0\u2013100] scale using EPIC\u201026 methodology. Correlations between QOL scores and dosimetric parameters were investigated, and the overall QOL differences between the two groups (QOL<jats:sub>Margin\u2010reduced<\/jats:sub>\u2010QOL<jats:sub>control<\/jats:sub>) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median QOL follow\u2010up length for the 20 patients was 48\u00a0months. Difference between delivered dose and planned dose did not reach statistical significance (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.1) for both targets and organs at risk between the two groups. At 4\u00a0years post\u2010RT, standardized mean QOL<jats:sub>Margin\u2010reduced<\/jats:sub>\u2010QOL<jats:sub>control<\/jats:sub> were improved for <jats:italic>Urinary Incontinence, Urinary Irritative\/Obstructive, Bowel<\/jats:italic>, and <jats:italic>Sexual<\/jats:italic> EPIC domains by 3.5, 14.8, 10.2, and 16.1, respectively (higher values better). The control group showed larger PTV\/rectum and PTV\/bladder intersection volumes (7.2\u00a0\u00b1\u00a05.8, 18.2\u00a0\u00b1\u00a08.1\u00a0cc) than the margin\u2010reduced group (2.6\u00a0\u00b1\u00a01.8, 12.5\u00a0\u00b1\u00a08.3\u00a0cc), though the dose to these intersection volumes did not reach statistical significance (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.1) between the groups. PTV\/rectum intersection volume showed a moderate correlation (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.56, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05) to <jats:italic>Bowel<\/jats:italic> EPIC domain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Results of this prospective study showed that margin\u2010reduced group exhibited clinically meaningful improvement of QOL without compromising the target dose coverage.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14198","type":"journal-article","created":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T18:13:31Z","timestamp":1699812811000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Radiation therapy margin reduction for patients with localized prostate cancer: A prospective study of the dosimetric impact and quality of life"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5508-9610","authenticated-orcid":false,"given":"Akila","family":"Kumarasiri","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indrin J.","family":"Chetty","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suneetha","family":"Devpura","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Aref","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Elshaikh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Henry Ford Health  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Movsas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Henry Ford Health  Detroit Michigan 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