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Open Access 01-12-2009 | Research

RapidArc, intensity modulated photon and proton techniques for recurrent prostate cancer in previously irradiated patients: a treatment planning comparison study

Authors: Damien C Weber, Hui Wang, Luca Cozzi, Giovanna Dipasquale, Haleem G Khan, Osman Ratib, Michel Rouzaud, Hansjoerg Vees, Habib Zaidi, Raymond Miralbell

Published in: Radiation Oncology | Issue 1/2009

Abstract

Background

A study was performed comparing volumetric modulated arcs (RA) and intensity modulation (with photons, IMRT, or protons, IMPT) radiation therapy (RT) for patients with recurrent prostate cancer after RT.

Methods

Plans for RA, IMRT and IMPT were optimized for 7 patients. Prescribed dose was 56 Gy in 14 fractions. The recurrent gross tumor volume (GTV) was defined on ¹⁸F-fluorocholine PET/CT scans. Plans aimed to cover at least 95% of the planning target volume with a dose > 50.4 Gy. A maximum dose (D_Max) of 61.6 Gy was allowed to 5% of the GTV. For the urethra, D_Max was constrained to 37 Gy. Rectal D_Median was < 17 Gy. Results were analyzed using Dose-Volume Histogram and conformity index (CI₉₀) parameters.

Results

Tumor coverage (GTV and PTV) was improved with RA (V_95% 92.6 ± 7.9 and 83.7 ± 3.3%), when compared to IMRT (V_95% 88.6 ± 10.8 and 77.2 ± 2.2%). The corresponding values for IMPT were intermediate for the GTV (V_95% 88.9 ± 10.5%) and better for the PTV (V_95%85.6 ± 5.0%). The percentages of rectal and urethral volumes receiving intermediate doses (35 Gy) were significantly decreased with RA (5.1 ± 3.0 and 38.0 ± 25.3%) and IMPT (3.9 ± 2.7 and 25.1 ± 21.1%), when compared to IMRT (9.8 ± 5.3 and 60.7 ± 41.7%). CI₉₀ was 1.3 ± 0.1 for photons and 1.6 ± 0.2 for protons. Integral Dose was 1.1 ± 0.5 Gy*cm³ *10⁵ for IMPT and about a factor three higher for all photon's techniques.

Conclusion

RA and IMPT showed improvements in conformal avoidance relative to fixed beam IMRT for 7 patients with recurrent prostate cancer. IMPT showed further sparing of organs at risk.

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Title: RapidArc, intensity modulated photon and proton techniques for recurrent prostate cancer in previously irradiated patients: a treatment planning comparison study
Authors: Damien C Weber
Hui Wang
Luca Cozzi
Giovanna Dipasquale
Haleem G Khan
Osman Ratib
Michel Rouzaud
Hansjoerg Vees
Habib Zaidi
Raymond Miralbell
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2009
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-4-34

Keynote webinar | Spotlight on medication adherence

Springer Medicine

RapidArc, intensity modulated photon and proton techniques for recurrent prostate cancer in previously irradiated patients: a treatment planning comparison study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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