Simulated real time image guided intrafraction tracking-delivery for hypofractionated prostate IMRT

Journal Article · Mon Sep 15 04:00:00 EDT 2008 · Medical Physics

DOI:https://doi.org/10.1118/1.2968333· OSTI ID:21120912

Hossain, Sabbir; Ping, Xia; Chuang, Cynthia; Verhey, Lynn; Gottschalk, Alexander R; Guanwei, Mu; Lijun, Ma ^[1]

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1. Department of Radiation Oncology, University of California San Francisco, San Francisco, California 94143-1708 (United States)

Hypofractionated stereotactic body radiotherapy (SBRT) has been tested for prostate cancer radiotherapy. This study aims to investigate the dosimetric effects of intrafraction prostate motion on the target and the normal structures for SBRT. For prostate cancer patients treated with an image-tracking CyberKnife system, the intrafraction prostate movements were recorded during 50-70 min treatment time. Based on the recorded intrafraction prostate movements, treatment plans were created for these cases using intensity modulated beams while scaling the average time patterns from the CyberKnife treatment to simulate hypofractionated intensity modulated radiotherapy (IMRT) delivery. The effect of delivery time on the intrafraction organ motion was investigated. For a nominal single fraction delivery of 9.5 Gy with IMRT, we found that the dosimetric effect of the intrafraction prostate movement is case dependent. For most cases, the dose volume histograms exhibited very small changes from the treatment plans that assumed no intrafractional prostate motion when the maximum intrafraction movements were within {+-}5 mm. However, when sporadic prostate movements greater than 5 mm were present in any one direction, significant changes were found. For example, the V{sub 100%} for the prostate could be reduced by more than 10% to less than 85% of the prostate volume coverage. If these large movements could be excluded by some active correction strategies, then the average V{sub 100%} for the simulated plan could be restored to within approximately 2% of the ideal treatment plans. On average, the sporadic intrafraction motion has less dosimetric impact on the prolonged treatment delivery versus fast treatment delivery. For example, the average V{sub 100%} for the clinical target volume was reduced from the original 95.1% to 92.1{+-} 3.7% for prolonged treatment, and to 91.3{+-}5.4% when the treatment time was shortened by 50%. Due to the observed large sporadic prostate motions, we conclude that an on-line target motion monitoring and correction strategy is necessary to implement hypofractionated SBRT with intensity modulated beams for prostate cancer treatments.

• OSTI ID: 21120912
• Journal Information: Medical Physics, Journal Name: Medical Physics Journal Issue: 9 Vol. 35; ISSN 0094-2405; ISSN MPHYA6
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
DOSIMETRY
IMAGES
PATIENTS
PROSTATE
RADIATION DOSES
RADIOTHERAPY
SIMULATION