The effect of anterior proton beams in the setting of a prostate-rectum spacer

Journal Article · Tue Oct 01 04:00:00 EDT 2013 · Medical Dosimetry

DOI:https://doi.org/10.1016/J.MEDDOS.2013.03.002· OSTI ID:22262829

Tang, Shikui ^[1]; Susil, Robert C.; McNutt, Todd R.; Song, Danny Y. ^[2]; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha ^[1]; DeWeese, Theodore L. ^[2]; Lu, Hsiao-Ming ^[3]; Both, Stefan ^[1]

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1. Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States)
2. Department of Radiation Oncology and Radiation Molecular Sciences, Johns Hopkins Hospital, Baltimore, MD (United States)
3. Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS.

• OSTI ID: 22262829
• Journal Information: Medical Dosimetry, Journal Name: Medical Dosimetry Journal Issue: 3 Vol. 38; ISSN 0958-3947
• Country of Publication: United States
• Language: English

Related Subjects

61 RADIATION PROTECTION AND DOSIMETRY
COMPUTERIZED TOMOGRAPHY
MAGNETIC RESONANCE
NEOPLASMS
PROSTATE
PROTON BEAMS
RADIATION DOSES
RECTUM