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Title: Helical Tomotherapy vs. Intensity-Modulated Proton Therapy for Whole Pelvis Irradiation in High-Risk Prostate Cancer Patients: Dosimetric, Normal Tissue Complication Probability, and Generalized Equivalent Uniform Dose Analysis

Abstract

Purpose: To compare intensity-modulated proton therapy (IMPT) and helical tomotherapy (HT) treatment plans for high-risk prostate cancer (HRPCa) patients. Methods and Materials: The plans of 8 patients with HRPCa treated with HT were compared with IMPT plans with two quasilateral fields set up (-100{sup o}; 100{sup o}) and optimized with the Hyperion treatment planning system. Both techniques were optimized to simultaneously deliver 74.2 Gy/Gy relative biologic effectiveness (RBE) in 28 fractions on planning target volumes (PTVs)3-4 (P + proximal seminal vesicles), 65.5 Gy/Gy(RBE) on PTV2 (distal seminal vesicles and rectum/prostate overlapping), and 51.8 Gy/Gy(RBE) to PTV1 (pelvic lymph nodes). Normal tissue calculation probability (NTCP) calculations were performed for the rectum, and generalized equivalent uniform dose (gEUD) was estimated for the bowel cavity, penile bulb and bladder. Results: A slightly better PTV coverage and homogeneity of target dose distribution with IMPT was found: the percentage of PTV volume receiving {>=}95% of the prescribed dose (V{sub 95%}) was on average >97% in HT and >99% in IMPT. The conformity indexes were significantly lower for protons than for photons, and there was a statistically significant reduction of the IMPT dosimetric parameters, up to 50 Gy/Gy(RBE) for the rectum and bowel and 60 Gy/Gy(RBE)more » for the bladder. The NTCP values for the rectum were higher in HT for all the sets of parameters, but the gain was small and in only a few cases statistically significant. Conclusions: Comparable PTV coverage was observed. Based on NTCP calculation, IMPT is expected to allow a small reduction in rectal toxicity, and a significant dosimetric gain with IMPT, both in medium-dose and in low-dose range in all OARs, was observed.« less

Authors:
 [1]; ;  [2];  [3];  [1];  [4];  [5]; ;  [3];  [4];  [2];  [1]
  1. Agenzia Provinciale per la Protonterapia, Trento (Italy)
  2. Department of Medical Physics, St. Raffaele Scientific Institute, Milan (Italy)
  3. Paul Scherrer Institut, Villigen (Switzerland)
  4. Department of Radiotherapy, St. Raffaele Scientific Institute, Milan (Italy)
  5. Section for Biomedical Physics, Universitatsklinik fur Radioonkologie, Tubingen (Germany)
Publication Date:
OSTI Identifier:
21587641
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2010.10.005; PII: S0360-3016(10)03422-X; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLADDER; COMPUTERIZED TOMOGRAPHY; CT-GUIDED RADIOTHERAPY; HAZARDS; IRRADIATION; LYMPH NODES; NEOPLASMS; PELVIS; PROSTATE; PROTONS; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RECTUM; BARYONS; BODY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; DOSES; ELEMENTARY PARTICLES; FERMIONS; GASTROINTESTINAL TRACT; GLANDS; HADRONS; INTESTINES; LARGE INTESTINE; LYMPHATIC SYSTEM; MALE GENITALS; MEDICINE; NUCLEAR MEDICINE; NUCLEONS; ORGANS; RADIOLOGY; RADIOTHERAPY; THERAPY; TOMOGRAPHY; URINARY TRACT

Citation Formats

Widesott, Lamberto, E-mail: widesott@yahoo.it, Pierelli, Alessio, Fiorino, Claudio, Lomax, Antony J., Amichetti, Maurizio, Cozzarini, Cesare, Soukup, Martin, Schneider, Ralf, Hug, Eugen, Di Muzio, Nadia, Calandrino, Riccardo, and Schwarz, Marco. Helical Tomotherapy vs. Intensity-Modulated Proton Therapy for Whole Pelvis Irradiation in High-Risk Prostate Cancer Patients: Dosimetric, Normal Tissue Complication Probability, and Generalized Equivalent Uniform Dose Analysis. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.10.005.
Widesott, Lamberto, E-mail: widesott@yahoo.it, Pierelli, Alessio, Fiorino, Claudio, Lomax, Antony J., Amichetti, Maurizio, Cozzarini, Cesare, Soukup, Martin, Schneider, Ralf, Hug, Eugen, Di Muzio, Nadia, Calandrino, Riccardo, & Schwarz, Marco. Helical Tomotherapy vs. Intensity-Modulated Proton Therapy for Whole Pelvis Irradiation in High-Risk Prostate Cancer Patients: Dosimetric, Normal Tissue Complication Probability, and Generalized Equivalent Uniform Dose Analysis. United States. doi:10.1016/j.ijrobp.2010.10.005.
Widesott, Lamberto, E-mail: widesott@yahoo.it, Pierelli, Alessio, Fiorino, Claudio, Lomax, Antony J., Amichetti, Maurizio, Cozzarini, Cesare, Soukup, Martin, Schneider, Ralf, Hug, Eugen, Di Muzio, Nadia, Calandrino, Riccardo, and Schwarz, Marco. Mon . "Helical Tomotherapy vs. Intensity-Modulated Proton Therapy for Whole Pelvis Irradiation in High-Risk Prostate Cancer Patients: Dosimetric, Normal Tissue Complication Probability, and Generalized Equivalent Uniform Dose Analysis". United States. doi:10.1016/j.ijrobp.2010.10.005.
@article{osti_21587641,
title = {Helical Tomotherapy vs. Intensity-Modulated Proton Therapy for Whole Pelvis Irradiation in High-Risk Prostate Cancer Patients: Dosimetric, Normal Tissue Complication Probability, and Generalized Equivalent Uniform Dose Analysis},
author = {Widesott, Lamberto, E-mail: widesott@yahoo.it and Pierelli, Alessio and Fiorino, Claudio and Lomax, Antony J. and Amichetti, Maurizio and Cozzarini, Cesare and Soukup, Martin and Schneider, Ralf and Hug, Eugen and Di Muzio, Nadia and Calandrino, Riccardo and Schwarz, Marco},
abstractNote = {Purpose: To compare intensity-modulated proton therapy (IMPT) and helical tomotherapy (HT) treatment plans for high-risk prostate cancer (HRPCa) patients. Methods and Materials: The plans of 8 patients with HRPCa treated with HT were compared with IMPT plans with two quasilateral fields set up (-100{sup o}; 100{sup o}) and optimized with the Hyperion treatment planning system. Both techniques were optimized to simultaneously deliver 74.2 Gy/Gy relative biologic effectiveness (RBE) in 28 fractions on planning target volumes (PTVs)3-4 (P + proximal seminal vesicles), 65.5 Gy/Gy(RBE) on PTV2 (distal seminal vesicles and rectum/prostate overlapping), and 51.8 Gy/Gy(RBE) to PTV1 (pelvic lymph nodes). Normal tissue calculation probability (NTCP) calculations were performed for the rectum, and generalized equivalent uniform dose (gEUD) was estimated for the bowel cavity, penile bulb and bladder. Results: A slightly better PTV coverage and homogeneity of target dose distribution with IMPT was found: the percentage of PTV volume receiving {>=}95% of the prescribed dose (V{sub 95%}) was on average >97% in HT and >99% in IMPT. The conformity indexes were significantly lower for protons than for photons, and there was a statistically significant reduction of the IMPT dosimetric parameters, up to 50 Gy/Gy(RBE) for the rectum and bowel and 60 Gy/Gy(RBE) for the bladder. The NTCP values for the rectum were higher in HT for all the sets of parameters, but the gain was small and in only a few cases statistically significant. Conclusions: Comparable PTV coverage was observed. Based on NTCP calculation, IMPT is expected to allow a small reduction in rectal toxicity, and a significant dosimetric gain with IMPT, both in medium-dose and in low-dose range in all OARs, was observed.},
doi = {10.1016/j.ijrobp.2010.10.005},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 80,
place = {United States},
year = {2011},
month = {8}
}