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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 6/2014

01-06-2014 | Original article

Planning study to compare dynamic and rapid arc techniques for postprostatectomy radiotherapy of prostate cancer

Authors: Dr. R. Cambria, M.Sc., F. Cattani, B.A. Jereczek-Fossa, F. Pansini, D. Ciardo, S. Vigorito, S. Russo, D. Zerini, L. Cozzi, R. Orecchia

Published in: Strahlentherapie und Onkologie | Issue 6/2014

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Abstract

Purpose

To compare our standard technique for postprostatectomy radiotherapy of prostate cancer, i.e. using two lateral conformal dynamic arcs with volumetric-modulated arc therapy (VMAT) performed with the RapidArc® (Varian Medical Systems, Palo Alto, CA, USA). The plans were referred to as DA and RA, respectively.

Materials and methods

The treatment plans of 44 patients receiving adjuvant/salvage radiotherapy in the first months of 2010 were compared. In all cases, the prescribed total dose was 66–68.2 Gy (2.2 Gy per fraction). Both DA and RA plans were optimized in terms of dose coverage and constraints.

Results

Small differences between the techniques were observed for planning target volume (PTV) dose distribution, whereas significant differences in sparing of organs at risk (OARs) were recorded (p < 0.0001). The OAR values (median; 95 % confidence interval, CI) were: rectum: D30 % = 60.7 Gy (59.40–62.04 Gy) and 48.2 Gy (46.40–52.72 Gy), D60 % = 34.1 Gy (28.50–38.92 Gy) and 27.7 Gy (21.80–31.51 Gy); bladder: D30 % = 57.3 Gy (45.83–64.53 Gy) and 46.4 Gy (33.23–61.48 Gy), D50 % = 16.4 Gy (11.89–42.38 Gy) and 17.2 Gy (10.97–27.90 Gy), for DA and RA, respectively. Treatment times were very similar, whereas the monitor units (MU) were 550 ± 29 versus 277 ± 3 for RA and DA, respectively.

Conclusion

Dose–volume histograms (DVHs) show improvements in OAR sparing with RA. However, the RA technique is associated with almost double the number of MUs compared to DA. Regarding the PTV, DA is slightly superior in terms of D2 % and dose homogeneity. On the whole, the results suggest that RA be the favorable technique.
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Metadata
Title
Planning study to compare dynamic and rapid arc techniques for postprostatectomy radiotherapy of prostate cancer
Authors
Dr. R. Cambria, M.Sc.
F. Cattani
B.A. Jereczek-Fossa
F. Pansini
D. Ciardo
S. Vigorito
S. Russo
D. Zerini
L. Cozzi
R. Orecchia
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 6/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-014-0601-9

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