CyberKnife-based prostate cancer patient radioablation – early results of irradiation in 200 patients

Miszczyk, Leszek; Napieralska, Aleksandra; Namysł-Kaletka, A.; Głowacki, Grzegorz; Grabińska, Kinga; Woźniak, Grzegorz; Stąpór-Fudzińska, Małgorzata

doi:10.5173/ceju.2015.582

Cited by 7 publications

(9 citation statements)

References 16 publications

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“…However, some of the resulting optimal plans would have long treatment times or large radiation exposures to the OARs. Long treatment times require patients to lie still for long periods of time, increasing their discomfort and the possibility they will move causing excess radiation to reach normal tissue [ 8 ]. Moreover, allowing long treatment times or excess irradiation to the OARs would conflict with our stated aims, so we did not use an objective function in which all terms were multiplied.…”

Section: Discussionmentioning

confidence: 99%

“…One study has reported that the time for prostate cancer treatment with CyberKnife was about 90 min per session [ 7 ]. However, other researchers have shown mean treatment times of 43 min, excluding the time needed for patient setup [ 6 ], and 40–65 min [ 8 ]. Each of these studies required longer mean treatment times than plans based on possible optimal combinations in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Despite its clear benefits, CyberKnife has long treatment times per session compared with 3D-CRT and IMRT, which have treatment times of about 10 min [ 5 ]. The need for repeated real-time x-ray imaging and the use of numerous beams result in treatment times for prostate cancer ranging between 40 to 90 min [ 6 – 8 ]. The length of the treatment time has a direct effect on patient discomfort, and consequently on setup errors during a session.…”

Section: Introductionmentioning

confidence: 99%

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A new plan quality objective function for determining optimal collimator combinations in prostate cancer treatment with stereotactic body radiation therapy using CyberKnife

et al. 2018

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Stereotactic body radiation therapy with CyberKnife for prostate cancer has long treatment times compared with conventional radiotherapy. This arises the need for designing treatment plans with short execution times. We propose an objective function for plan quality evaluation, which was used to determine an optimal combination between small and large collimators based on short treatment times and clinically acceptable dose distributions. Data from 11 prostate cancer patients were used. For each patient, 20 plans were created based on all combinations between one small (⌀ 10–25 mm) and one large (⌀ 35–60 mm) Iris collimator size. The objective function was assigned to each combination as a penalty, such that plans with low penalties were considered superior. This function considered the achievement of dosimetric planning goals, tumor control probability, normal tissue complication probability, relative seriality parameter, and treatment time. Two methods were used to determine the optimal combination. First, we constructed heat maps representing the mean penalty values and standard deviations of the plans created for each collimator combination. The combination giving a plan with the smallest mean penalty and standard deviation was considered optimal. Second, we created two groups of superior plans: group A plans were selected by histogram analysis and group B plans were selected by choosing the plan with the lowest penalty from each patient. In both groups, the most used small and large collimators were assumed to represent the optimal combination. The optimal combinations obtained from the heat maps included the 25 mm as a small collimator, giving small/large collimator sizes of 25/35, 25/40, 25/50, and 25/60 mm. The superior-group analysis indicated that 25/50 mm was the optimal combination. The optimal Iris combination for prostate cancer treatment using CyberKnife was determined to be a collimator size between 25 mm (small) and 50 mm (large).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A new plan quality objective function for determining optimal collimator combinations in prostate cancer treatment with stereotactic body radiation therapy using CyberKnife

et al. 2018

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“…W badaniu przeprowadzonym przez zespół Miszczyka [6], w którym najdłuższy czas obserwacji wyniósł 26 miesiące, odnotowano stosunkowo niski odsetek działań niepożądanych zastosowanej terapii. Ostre odczyny popromienne ze strony układu moczowego w stopniu 2 według RTOG dotyczyły 8,5%, a w stopniu 3 -1% chorych.…”

Section: Omówienieunclassified

Jakość życia pacjentów w trakcie leczenia radioterapią SBRT na aparacie CyberKnife z powodu raka prostaty

Konkol

2017

los

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StreszczenieCel: Celem pracy była ocena jakości życia pacjentów z nowotworem prostaty podczas radioterapii stereotaktycznej.Metoda i materiały: 91 pacjentów ze zlokalizowanym gruczolakorakiem prostaty niskiego i średniego ryzyka zostało poddanych naświetlaniu za pomocą systemu radiochirurgii CyberKnife. Przepisana dawka wynosiła 35-36,25 Gy w 5 frakcjach. Jakość życia zmierzono za pomocą kwestionariusza EORTC QLQ-C30 (v 3.0) oraz modułu EORTC QLQ-PR25 właściwego dla prostaty. Dodatkowe dane dotyczące objawów właściwych dla prostaty zostały ocenione przy użyciu kwestionariusza IPSS (International Prostate Symptom Score). Pacjenci zostali poproszeni o wypełnienie formularzy przed leczeniem i po jego zakończeniu.Wyniki: Nie stwierdzono istotnych różnic podczas porównywania pytań służących do pomiaru ogólnego stanu zdrowia oraz po zakończeniu leczenia (znormalizowany wynik 60 wobec 57). Wśród wszystkich badanych objawów statystycznie istotne były jedynie nasilenie biegunki oraz zaburzenia układu moczowego. Nasilenie zaburzeń układu moczowego zaobserwowano we wszystkich punktach kwestionariusza IPSS. Odnotowano wzrost średniego łącznego wyniku IPSS z 8 punktów przed radioterapią do 17 punktów tuż po piątej frakcji. Przed rozpoczęciem leczenia 47% łącznej liczby pacjentów wykazywało łagodne objawy, 42% -umiarkowane, a 11% -ostre. Po przeprowadzeniu cyklu SBRT zaledwie 19% pacjentów zgłaszało łagodne objawy, 42% -umiarkowane, a 39% -ostre.Wnioski: Badania wykazały, że mimo nasilania objawów z układu moczowego i jelit ogólna jakość życia nie uległa znaczącej zmianie podczas leczenia, co świadczy o tym, że stereotaktyczna radioterapia za pomocą systemu CyberKnife jest metodą dobrze tolerowaną przez pacjentów.Adres do korespondencji

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“…This system is used for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) applications. The efficacy of SRS [2,3] and SBRT [4][5][6] applications were demonstrated by large body of literature. In recent years, small field dosimetry gain increased attention and several investigations are going on, to address the issues associated with small fields [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Can Gafchromic EBT3 films effectively characterize small fields of 6 MV unflattened photon beams of Cyberknife system?

Amalraj

Ramasubramanian

Pichandi

2018

Polish Journal of Medical Physics and Engineering

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Shielded silicon diodes are commonly employed in commissioning of Cyberknife 6 MV photon beams. This study aims to measure output factors, off centered ratio (OCR), percentage depth dose (PDD) of 6 MV photons using shielded and unshielded diodes and to compare with Gafchromic EBT3 film measurements to investigate whether EBT3 could effectively characterize small 6 MV photon beams. Output factors, OCR and PDD were measured with shielded and unshielded silicon detectors in a radiation field analyzer system at reference condition. Water equivalent solid phantom were used while irradiating EBT3 films. From multiuser data, diodes underestimated output factor by 3% for collimator fields ≤ 10 mm, while EBT3 underestimated the output factor by 3.9% for 5 mm collimator. 1D Gamma analysis of OCR between diode and film, results in gamma ≤ 1 for all measured points with 1 mm distance to agreement (DTA) and 1% relative dose difference (DD). Dose at surface is overestimated with diodes compared to EBT3. PDD results were within 2% relative dose values between diode and EBT3 except for 5 mm collimator. Except for small collimator fields of up to 10 mm, results of output factor, OCR, PDD of all detectors used in this study exhibited similar results. Relative dose measurements with Gafchromic EBT3 in this work show that EBT3 films can be used effectively as an independent tool to verify commissioning beam data of small fields only after careful verification of methodology for any systematic errors with appropriate readout procedure.

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CyberKnife-based prostate cancer patient radioablation – early results of irradiation in 200 patients

Cited by 7 publications

References 16 publications

A new plan quality objective function for determining optimal collimator combinations in prostate cancer treatment with stereotactic body radiation therapy using CyberKnife

A new plan quality objective function for determining optimal collimator combinations in prostate cancer treatment with stereotactic body radiation therapy using CyberKnife

Jakość życia pacjentów w trakcie leczenia radioterapią SBRT na aparacie CyberKnife z powodu raka prostaty

Can Gafchromic EBT3 films effectively characterize small fields of 6 MV unflattened photon beams of Cyberknife system?

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