Coplanar intensity-modulated radiotherapy class solution for patients with prostate cancer with bilateral hip prostheses with and without nodal involvement

Journal Article · Mon Jul 01 04:00:00 EDT 2013 · Medical Dosimetry

DOI:https://doi.org/10.1016/J.MEDDOS.2012.10.007· OSTI ID:22264100

McVey, Gerard P. ^[1]; South, Chris P. ^[2]; Dearnaley, David P. ^[1]

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1. Academic Radiotherapy Unit, Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Sutton, Surrey SM2 5PT (United Kingdom)
2. Joint Department of Physics, The Royal Marsden NHS Foundation Trust, Sutton, Surrey SM2 5PT (United Kingdom)

Dose distributions for prostate radiotherapy are difficult to predict in patients with bilateral hip prostheses in situ, due to image distortions and difficulty in dose calculation. The feasibility of delivering curative doses to prostate using intensity-modulated radiotherapy (IMRT) in patients with bilateral hip prostheses was evaluated. Planning target volumes for prostate only (PTV1) and pelvic nodes (PTV2) were generated from data on 5 patients. PTV1 and PTV2 dose prescriptions were 70 Gy and 60 Gy, respectively, in 35 fractions, and an additional nodal boost of 65 Gy was added for 1 plan. Rectum, bladder, and bowel were also delineated. Beam angles and segments were chosen to best avoid entering through the prostheses. Dose-volume data were assessed with respect to clinical objectives. The plans achieved the required prescription doses to the PTVs. Five-field IMRT plans were adequate for patients with relatively small prostheses (head volumes<60 cm{sup 3}) but 7-field plans were required for patients with larger prostheses. Bowel and bladder doses were clinically acceptable for all patients. Rectal doses were deemed clinically acceptable, although the V{sub 50} {sub Gy} objective was not met for 4/5 patients. We describe an IMRT solution for patients with bilateral hip prostheses of varying size and shape, requiring either localized or whole pelvic radiotherapy for prostate cancer.

• OSTI ID: 22264100
• Journal Information: Medical Dosimetry, Journal Name: Medical Dosimetry Journal Issue: 2 Vol. 38; ISSN 0958-3947
• Country of Publication: United States
• Language: English

Related Subjects

61 RADIATION PROTECTION AND DOSIMETRY
62 RADIOLOGY AND NUCLEAR MEDICINE
EXTERNAL BEAM RADIATION THERAPY
PLANNING
PROSTATE
PROSTHESES
RADIATION DOSE DISTRIBUTIONS