Postoperative intensity modulated radiation therapy in high risk prostate cancer: a dosimetric comparison

Francesco Deodato, Gian Carlo Mattiucci, Savino Cilla, Anna Maria De Gaetano, Mariangela Massaccesi, Gabriella Macchia, Edy Ippolito, Simona Panunzi, Elisa D'Angelo, Viola Valentini, Numa Cellini, Alessia Piermattei, C Digesú, C Iapalucci, Gda Padula, Ag Morganti

Risultato della ricerca: Contributo in rivistaArticolo in rivista

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 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.
Lingua originaleEnglish
pagine (da-a)231-239
Numero di pagine9
RivistaMedical Dosimetry
Volume36
DOI
Stato di pubblicazionePubblicato - 2011

Keywords

  • Aged
  • Combined Modality Therapy
  • Humans
  • Male
  • Middle Aged
  • Prostatic Neoplasms
  • Radiometry
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated

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