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Title: Dosimetric Comparison of High-Dose-Rate Brachytherapy and Intensity-Modulated Radiation Therapy as a Boost to the Prostate

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
 [1]; ;  [1];  [2];  [3]
  1. Department of Radiation Oncology, Liege University Hospital, Liege (Belgium)
  2. Department of Medical Physics, Liege University Hospital, Liege (Belgium)
  3. Department of Radiation Oncology, Oscar Lambret Center, Lille (France)

Purpose: We compared the dose conformity of two radiation modalities: high-dose-rate brachytherapy (HDR BT) and intensity-modulated radiation therapy (IMRT) to deliver a boost to the prostate after external beam radiotherapy (EBRT). Methods and Materials: Ten successive patients with prostate adenocarcinoma treated with a single 10-Gy HDR BT boost after EBRT were investigated. Four theoretical IMRT plans were computed: (a) 32.85 Gy IMRT and (b) 26 Gy IMRT with CTV-PTV expansions, doses corresponding to the equivalent dose in 2-Gy fractions (EQD2) of one 10-Gy fraction calculated with a prostate alpha/beta ratio of respectively 1.5 and 3 Gy; and (c) 32.85 Gy IMRT and (d) 26 Gy IMRT without CTV-PTV expansions. The dose-volume histogram values converted in EQD2 with an alpha/beta ratio of 3 Gy for the organs at risk were compared. Results: The HDR BT plan delivered higher mean doses to the PTV compared with IMRT plans. In all, 33% of the rectal volume received a mean dose of 5.32 +- 0.65 Gy and 20% of bladder volume received 4.61 +- 1.24 Gy with HDR BT. In comparison, doses delivered with IMRT were respectively 13.4 +- 1.49 Gy and 10.81 +- 4 Gy, even if only 26 Gy was prescribed to the PTV with no CTV-PTV expansion (p < 0.0001). The hot spots inside the urethra were greater with HDR BT but acceptable. Conclusions: Use of HDR BT produced a more conformal plan for the boost to the prostate than IMRT even without CTV-PTV expansions.

OSTI ID:
21367614
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Vol. 76, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2009.05.046; PII: S0360-3016(09)00825-6; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
Country of Publication:
United States
Language:
English