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Title: Evaluation of image-guided radiation therapy (IGRT) technologies and their impact on the outcomes of hypofractionated prostate cancer treatments: A radiobiologic analysis

Abstract

Purpose: To quantify the mitigation of geometric uncertainties achieved with the application of various patient setup techniques during the delivery of hypofractionated prostate cancer treatments, using tumor control probability (TCP) and normal tissue complication probability. Methods and Materials: Five prostate cancer patients with {approx}16 treatment CT studies, taken during the course of their radiation therapy (77 total), were analyzed. All patients were planned twice with an 18 MV six-field conformal technique, with 10- and 5-mm margin sizes, with various hypofractionation schedules (5 to 35 fractions). Subsequently, four clinically relevant patient setup techniques (laser guided and image guided) were simulated to deliver such schedules. Results: As hypothesized, the impact of geometric uncertainties on clinical outcomes increased with more hypofractionated schedules. However, the absolute gain in TCP due to hypofractionation (up to 21.8% increase) was significantly higher compared with the losses due to geometric uncertainties (up to 8.6% decrease). Conclusions: The results of this study suggest that, although the impact of geometric uncertainties on the treatment outcomes increases as the number of fractions decrease, the reduction in TCP due to the uncertainties does not significantly offset the expected theoretical gain in TCP by hypofractionation.

Authors:
 [1];  [2];  [3];  [1];  [2];  [1];  [2];  [2];  [4]
  1. Radiation Treatment Program, London Regional Cancer Program, London Health Sciences Centre, London, Ontario (Canada)
  2. (Canada)
  3. Department of Medical Physics, Toronto Sunnybrook Cancer Centre, Sunnybrook and Women's Health Sciences Centre, Toronto, Ontario (Canada)
  4. Radiation Treatment Program, London Regional Cancer Program, London Health Sciences Centre, London, Ontario (Canada) and Department of Medical Biophysics, University of Western Ontario, London, Ontario (Canada) and Department of Oncology, University of Western Ontario, London, Ontario (Canada). E-mail: jake.vandyk@lhsc.on.ca
Publication Date:
OSTI Identifier:
20788297
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2005.08.037; PII: S0360-3016(05)02582-4; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; EVALUATION; IMAGES; MATERIALS; PATIENTS; PROSTATE; RADIOTHERAPY

Citation Formats

Song, William Y., Department of Medical Biophysics, University of Western Ontario, London, Ontario, Schaly, Bryan, Bauman, Glenn, Department of Oncology, University of Western Ontario, London, Ontario, Battista, Jerry J., Department of Medical Biophysics, University of Western Ontario, London, Ontario, Department of Oncology, University of Western Ontario, London, Ontario, and Van Dyk, Jake. Evaluation of image-guided radiation therapy (IGRT) technologies and their impact on the outcomes of hypofractionated prostate cancer treatments: A radiobiologic analysis. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Song, William Y., Department of Medical Biophysics, University of Western Ontario, London, Ontario, Schaly, Bryan, Bauman, Glenn, Department of Oncology, University of Western Ontario, London, Ontario, Battista, Jerry J., Department of Medical Biophysics, University of Western Ontario, London, Ontario, Department of Oncology, University of Western Ontario, London, Ontario, & Van Dyk, Jake. Evaluation of image-guided radiation therapy (IGRT) technologies and their impact on the outcomes of hypofractionated prostate cancer treatments: A radiobiologic analysis. United States. doi:10.1016/J.IJROBP.2005.0.
Song, William Y., Department of Medical Biophysics, University of Western Ontario, London, Ontario, Schaly, Bryan, Bauman, Glenn, Department of Oncology, University of Western Ontario, London, Ontario, Battista, Jerry J., Department of Medical Biophysics, University of Western Ontario, London, Ontario, Department of Oncology, University of Western Ontario, London, Ontario, and Van Dyk, Jake. Sun . "Evaluation of image-guided radiation therapy (IGRT) technologies and their impact on the outcomes of hypofractionated prostate cancer treatments: A radiobiologic analysis". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20788297,
title = {Evaluation of image-guided radiation therapy (IGRT) technologies and their impact on the outcomes of hypofractionated prostate cancer treatments: A radiobiologic analysis},
author = {Song, William Y. and Department of Medical Biophysics, University of Western Ontario, London, Ontario and Schaly, Bryan and Bauman, Glenn and Department of Oncology, University of Western Ontario, London, Ontario and Battista, Jerry J. and Department of Medical Biophysics, University of Western Ontario, London, Ontario and Department of Oncology, University of Western Ontario, London, Ontario and Van Dyk, Jake},
abstractNote = {Purpose: To quantify the mitigation of geometric uncertainties achieved with the application of various patient setup techniques during the delivery of hypofractionated prostate cancer treatments, using tumor control probability (TCP) and normal tissue complication probability. Methods and Materials: Five prostate cancer patients with {approx}16 treatment CT studies, taken during the course of their radiation therapy (77 total), were analyzed. All patients were planned twice with an 18 MV six-field conformal technique, with 10- and 5-mm margin sizes, with various hypofractionation schedules (5 to 35 fractions). Subsequently, four clinically relevant patient setup techniques (laser guided and image guided) were simulated to deliver such schedules. Results: As hypothesized, the impact of geometric uncertainties on clinical outcomes increased with more hypofractionated schedules. However, the absolute gain in TCP due to hypofractionation (up to 21.8% increase) was significantly higher compared with the losses due to geometric uncertainties (up to 8.6% decrease). Conclusions: The results of this study suggest that, although the impact of geometric uncertainties on the treatment outcomes increases as the number of fractions decrease, the reduction in TCP due to the uncertainties does not significantly offset the expected theoretical gain in TCP by hypofractionation.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 64,
place = {United States},
year = {Sun Jan 01 00:00:00 EST 2006},
month = {Sun Jan 01 00:00:00 EST 2006}
}