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| Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2015 Sep 6. pii: S0167-8140(15)00382-5. doi: 10.1016/j.radonc.2015.07.028 |
| Feasibility of dominant intraprostatic lesion boosting using advanced photon-, proton- or brachytherapy. |
| Andrzejewski P1, Kuess P2, Knäusl B3, Pinker K4, Georg P5, Knoth J6, Berger D7, Kirisits C8, Goldner G9, Helbich T10, Pötter R11, Georg D12 |
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Abstract BACKGROUND AND PURPOSE: Advancements in imaging and dose delivery enable boosting of the dominant intraprostatic lesions (DIL), while maintaining organs-at-risk (OAR) tolerances. This study aimed to assess the feasibility of DIL boosting for volumetric modulated arc therapy (VMAT), intensity modulated proton therapy (IMPT) and high dose rate brachytherapy (HDR-BT). MATERIAL AND METHODS: DILs were defined on multiparametric magnetic resonance imaging and fused with planning CT for twelve patients. VMAT, IMPT and HDR-BT plans were created for each patient with an EQD2α/β DIL aimed at 111.6Gy, PTVinitialDpres was 80.9Gy (EBRT) with CTV D90%=81.9Gy (HDR-BT). Hard dose constraints were applied for OARs. RESULTS: Higher boost doses were achieved with IMPT compared to VMAT, keeping major OAR doses at similar levels. Patient averaged EQD2α/β D50% to DIL were 110.7, 114.2 and 150.1Gy(IsoE) for VMAT, IMPT and HDR-BT, respectively. Respective rectal wall Dmean were 30.5±5.0, 16.7±3.6, 9.5±2.5Gy(IsoE) and bladder wall Dmean were 21.0±5.5, 15.6±4.3 and 6.3±2.2Gy(IsoE). CONCLUSIONS: DIL boosting was found to be feasible with all investigated techniques. Although OAR doses were higher than for standard treatment approach, the risk levels were reasonably low. HDR-BT was superior to VMAT and IMPT, both in terms of OAR sparing and DIL boosting. |
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Copyright © 2015 Elsevier Ireland Ltd. All rights reserved. |
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KEYWORDS: DIL, HDR-BT, IMPT, Prostate cancer, SIB, VMAT |
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Publikations ID: 26349588 Quelle: öffnen |
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