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Title: Postoperative Intensity Modulated Radiation Therapy in High Risk Prostate Cancer: A Dosimetric Comparison

Abstract

The aim of this study was to compare intensity-modulated radiation therapy (IMRT) with 3D conformal technique (3D-CRT), with respect to target coverage and irradiation of organs at risk for high dose postoperative radiotherapy (PORT) of the prostate fossa. 3D-CRT and IMRT treatment plans were compared with respect to dose to the rectum and bladder. The dosimetric comparison was carried out in 15 patients considering 2 different scenarios: (1) exclusive prostate fossa irradiation, and (2) pelvic node irradiation followed by a boost on the prostate fossa. In scenario (1), a 3D-CRT plan (box technique) and an IMRT plan were calculated and compared for each patient. In scenario (2), 3 treatment plans were calculated and compared for each patient: (a) 3D-CRT box technique for both pelvic (prophylactic nodal irradiation) and prostate fossa irradiation (3D-CRT only); (b) 3D-CRT box technique for pelvic irradiation followed by an IMRT boost to the prostatic fossa (hybrid 3D-CRT and IMRT); and (c) IMRT for both pelvic and prostate fossa irradiation (IMRT only). For exclusive prostate fossa irradiation, IMRT significantly reduced the dose to the rectum (lower Dmean, V50%, V75%, V90%, V100%, EUD, and NTCP) and the bladder (lower Dmean, V50%, V90%, EUD and NTCP). When prophylactic irradiationmore » of the pelvis was also considered, plan C (IMRT only) performed better than plan B (hybrid 3D-CRT and IMRT) as respect to both rectum and bladder irradiation (reduction of Dmean, V50%, V75%, V90%, equivalent uniform dose [EUD], and normal tissue complication probability [NTCP]). Plan (b) (hybrid 3D-CRT and IMRT) performed better than plan (a) (3D-CRT only) with respect to dose to the rectum (lower Dmean, V75%, V90%, V100%, EUD, and NTCP) and the bladder (Dmean, EUD, and NTCP). Postoperative IMRT in prostate cancer significantly reduces rectum and bladder irradiation compared with 3D-CRT.« less

Authors:
 [1];  [2];  [3];  [1];  [1]; ;  [1];  [3];  [1];  [4];  [1];  [5]; ;  [4]
  1. Department of Radiotherapy, 'John Paul II' Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso (Italy)
  2. Department of Medical Physics, 'John Paul II' Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso (Italy)
  3. CNR-Institute of Systems Analysis and Computer Science (IASI), BioMathLab, Rome (Italy)
  4. Department of Radiotherapy, Policlinico Universitario 'A. Gemelli,' Catholic University, Rome (Italy)
  5. Department of Radiation Oncology, The Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI (United States)
Publication Date:
OSTI Identifier:
21590488
Resource Type:
Journal Article
Journal Name:
Medical Dosimetry
Additional Journal Information:
Journal Volume: 36; Journal Issue: 3; Other Information: DOI: 10.1016/j.meddos.2010.03.009; PII: S0958-3947(10)00036-1; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0958-3947
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; BLADDER; DOSIMETRY; HAZARDS; IRRADIATION; NEOPLASMS; PELVIS; PROSTATE; RADIATION DOSES; RADIOTHERAPY; RECTUM; BODY; DIGESTIVE SYSTEM; DISEASES; DOSES; GASTROINTESTINAL TRACT; GLANDS; INTESTINES; LARGE INTESTINE; MALE GENITALS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; THERAPY; URINARY TRACT

Citation Formats

Digesu, Cinzia, Cilla, Savino, De Gaetano, Andrea, Massaccesi, Mariangela, Macchia, Gabriella, Ippolito, Edy, Deodato, Francesco, Panunzi, Simona, Iapalucci, Chiara, Mattiucci, Gian Carlo, D'Angelo, Elisa, Padula, Gilbert D.A., Valentini, Vincenzo, and Cellini, Numa. Postoperative Intensity Modulated Radiation Therapy in High Risk Prostate Cancer: A Dosimetric Comparison. United States: N. p., 2011. Web. doi:10.1016/j.meddos.2010.03.009.
Digesu, Cinzia, Cilla, Savino, De Gaetano, Andrea, Massaccesi, Mariangela, Macchia, Gabriella, Ippolito, Edy, Deodato, Francesco, Panunzi, Simona, Iapalucci, Chiara, Mattiucci, Gian Carlo, D'Angelo, Elisa, Padula, Gilbert D.A., Valentini, Vincenzo, & Cellini, Numa. Postoperative Intensity Modulated Radiation Therapy in High Risk Prostate Cancer: A Dosimetric Comparison. United States. https://doi.org/10.1016/j.meddos.2010.03.009
Digesu, Cinzia, Cilla, Savino, De Gaetano, Andrea, Massaccesi, Mariangela, Macchia, Gabriella, Ippolito, Edy, Deodato, Francesco, Panunzi, Simona, Iapalucci, Chiara, Mattiucci, Gian Carlo, D'Angelo, Elisa, Padula, Gilbert D.A., Valentini, Vincenzo, and Cellini, Numa. 2011. "Postoperative Intensity Modulated Radiation Therapy in High Risk Prostate Cancer: A Dosimetric Comparison". United States. https://doi.org/10.1016/j.meddos.2010.03.009.
@article{osti_21590488,
title = {Postoperative Intensity Modulated Radiation Therapy in High Risk Prostate Cancer: A Dosimetric Comparison},
author = {Digesu, Cinzia and Cilla, Savino and De Gaetano, Andrea and Massaccesi, Mariangela and Macchia, Gabriella and Ippolito, Edy and Deodato, Francesco and Panunzi, Simona and Iapalucci, Chiara and Mattiucci, Gian Carlo and D'Angelo, Elisa and Padula, Gilbert D.A. and Valentini, Vincenzo and Cellini, Numa},
abstractNote = {The aim of this study was to compare intensity-modulated radiation therapy (IMRT) with 3D conformal technique (3D-CRT), with respect to target coverage and irradiation of organs at risk for high dose postoperative radiotherapy (PORT) of the prostate fossa. 3D-CRT and IMRT treatment plans were compared with respect to dose to the rectum and bladder. The dosimetric comparison was carried out in 15 patients considering 2 different scenarios: (1) exclusive prostate fossa irradiation, and (2) pelvic node irradiation followed by a boost on the prostate fossa. In scenario (1), a 3D-CRT plan (box technique) and an IMRT plan were calculated and compared for each patient. In scenario (2), 3 treatment plans were calculated and compared for each patient: (a) 3D-CRT box technique for both pelvic (prophylactic nodal irradiation) and prostate fossa irradiation (3D-CRT only); (b) 3D-CRT box technique for pelvic irradiation followed by an IMRT boost to the prostatic fossa (hybrid 3D-CRT and IMRT); and (c) IMRT for both pelvic and prostate fossa irradiation (IMRT only). For exclusive prostate fossa irradiation, IMRT significantly reduced the dose to the rectum (lower Dmean, V50%, V75%, V90%, V100%, EUD, and NTCP) and the bladder (lower Dmean, V50%, V90%, EUD and NTCP). When prophylactic irradiation of the pelvis was also considered, plan C (IMRT only) performed better than plan B (hybrid 3D-CRT and IMRT) as respect to both rectum and bladder irradiation (reduction of Dmean, V50%, V75%, V90%, equivalent uniform dose [EUD], and normal tissue complication probability [NTCP]). Plan (b) (hybrid 3D-CRT and IMRT) performed better than plan (a) (3D-CRT only) with respect to dose to the rectum (lower Dmean, V75%, V90%, V100%, EUD, and NTCP) and the bladder (Dmean, EUD, and NTCP). Postoperative IMRT in prostate cancer significantly reduces rectum and bladder irradiation compared with 3D-CRT.},
doi = {10.1016/j.meddos.2010.03.009},
url = {https://www.osti.gov/biblio/21590488}, journal = {Medical Dosimetry},
issn = {0958-3947},
number = 3,
volume = 36,
place = {United States},
year = {Sat Oct 01 00:00:00 EDT 2011},
month = {Sat Oct 01 00:00:00 EDT 2011}
}