IMRT boost dose planning on dominant intraprostatic lesions: Gold marker-based three-dimensional fusion of CT with dynamic contrast-enhanced and 1H-spectroscopic MRI

Lin, Emile N.J.T. van; Fütterer, Jurgen J.; Heijmink, Stijn W. T. P. J.; Vight, Lisette P. van der; Hoffmann, Aswin L.; Kollenburg, Peter van; Huisman, Henkjan; Scheenen, Tom W. J.; Witjes, J. Alfred; Leer, J.W.H.; Barentsz, Jelle O.; Visser, A.G.

doi:10.1016/j.ijrobp.2005.12.046

Cited by 162 publications

(107 citation statements)

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“…Following head-and-neck cancer practice, the doses prescribed to the pelvic lymph nodes could have been differentiated, with a higher dose to positive or radiologically suspect lymph nodes. It also seems justified to introduce yet another dose differentiation, as a higher dose could be prescribed to either the whole prostate (e.g., without margins) or to parts of the prostate, in the latter situation guided by magnetic resonance imaging or magnetic resonance spectroscopy (40,41) or by positron emission tomography or computed tomography (42). In a recent study, Jacob et al showed considerable benefit, in terms of biochemical control, from prescribing doses greater than 70 Gy to intermediate and high-risk prostate cancer patients (43).…”

Section: Discussionmentioning

confidence: 99%

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Muren

Wasbø

Helle

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose: We present planning and early clinical outcomes of a study of intensity-modulated radiotherapy (IMRT) for locally advanced prostate cancer. Methods and Materials: A total of 43 patients initially treated with an IMRT plan delivering 50 Gy to the prostate, seminal vesicles, and pelvic lymph nodes, followed by a conformal radiotherapy (CRT) plan delivering 20 Gy to the prostate and seminal vesicles, were studied. Dose-volume histogram (DVH) data for the added plans were compared with dose-volume histogram data for the sum of two CRT plans for 15 cases. Gastrointestinal (GI) and genitourinary (GU) toxicity, based on the Radiation Therapy Oncology Group scoring system, was recorded weekly throughout treatment as well as 3 to 18 months after treatment and are presented. Results: Treatment with IMRT both reduced normal tissue doses and increased the minimum target doses. Intestine volumes receiving more than 40 and 50 Gy were significantly reduced (e.g., at 50 Gy, from 81 to 19 cm 3 ; p = 0.026), as were bladder volumes above 40, 50, and 60 Gy, rectum volumes above 30, 50, and 60 Gy, and hip joint muscle volumes above 20, 30, and 40 Gy. During treatment, Grade 2 GI toxicity was reported by 12 of 43 patients (28%), and Grade 2 to 4 GU toxicity was also observed among 12 patients (28%). With 6 to 18 months of follow-up, 2 patients (5%) experienced Grade 2 GI effects and 7 patients (16%) experienced Grade 2 GU effects. Conclusions: Use of IMRT for pelvic irradiation in prostate cancer reduces normal tissue doses, improves target coverage, and has a promising toxicity profile. Ó

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Section: Discussionmentioning

confidence: 99%

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Muren

Wasbø

Helle

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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“…Selective boosting scenarios (1) SB90-70 (delivering an equivalent uniform dose (EUD) of 90 Gy to the nodule and an EUD of 70 Gy to the rPTV delivered in 35 fractions (fx)/2 Gy to 100% of the PTV) and (2) SB80-74 (37 fx / 2 Gy to 100% of the PTV) are based on recently published studies [2][3][14][15]. Selective boosting scenario (3) SB91-81 designed to study a more aggressive selective boosting IMRT strategy employing physical dose constraints and selective boosting scenario (4) risk-adaptive optimization employing a biological objective function (cf.…”

Section: Imrt Treatment Planning For Four Different Selective Boostinmentioning

confidence: 99%

“…Currently, the integration of biological information into radiotherapy (RT) treatment planning with the aim of boosting high-risk tumor subvolumes is of great interest [1][2][3][4][5][6][7][8] -this concept has been termed either 'selective boosting' [4][5][6] or 'dose painting' [7][8]. To achieve selective boosting IMRT based on patient-specific biological information, the following techniques and methods have to be available: a highly conformal RT delivery technique, a method to decide on the boosting level, and a functional or molecular imaging modality having high imaging accuracy.…”

Section: Introductionmentioning

confidence: 99%

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On the impact of functional imaging accuracy on selective boosting IMRT

Kim

2009

Physica Medica

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In order to quantify the impact of loss of functional imaging sensitivity and specificity on tumor control and normal tissue toxicity for selective boosting IMRT four selective boosting scenarios were designed: SB91-81 (EUD=91Gy for the high risk tumor subvolume and EUD=81Gy for a remaining low risk PTV (rPTV)), SB80-74, SB90-70, and risk-adaptive optimization. For each sensitivity loss level the loss in tumor control probability (ΔTCP) was calculated. For each specificity loss level, the increase in rectal and the bladder toxicity was quantified using the radiobiological indices (equivalent uniform dose (EUD) and normal tissue complication probability (NTCP)) and %-volumes irradiated.The impact of loss in sensitivity on local tumor control was maximal when the prescription dose level for rPTV had the lowest value. The SB90-70 plan had a ΔTCP= 29.6%, the SB91-81 plan had a ΔTCP = 9.5%, while for risk-adaptive optimization a ΔTCP= 4.7% was found. Independent of planning technique loss in functional imaging specificity appears to have a minimal impact on the expected normal tissue toxicity, since an increase in rectal or bladder toxicity as a function of loss in specificity was not observed. Additionally, all plans fulfilled the rectum and the bladder sparing criteria found in the literature for late rectal bleeding and genitourinary complications.Our study shows that the choice of a low-risk classification for the rPTV in selective boosting IMRT may lead to a significant loss in TCP. Furthermore, for the example considered in which normal tissue complications can be limited through the use of a tissue expander it appears that the therapeutic ratio can be improved using a functional imaging technique with a high sensitivity and limited specificity. While for cases were this is not possible an optimal balance between sensitivity and specificity has to be found.

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“…To compare two contouring techniques, radiobiological modeling could be a suitable approach in brachytherapy treatments. Additionally, studies have shown that contouring based on MRI images with better soft tissue contrast provides better results than CT images in radiation therapy [44][45][46][47][48]. In this regard, a radiobiological comparison was conducted to study the benefits of using MRI for treatment planning relative to CT-based planning for temporary implant prostate brachytherapy [11].…”

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confidence: 99%

An Overview on the Clinical Application of Radiobiological Modeling in Radiation Therapy of Cancer

Mesbahi

Oladghaffari

2017

IJRRT

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Analyzing the dose distribution inside target volumes of cancer patients before radiation delivery and then selection of the biologically optimal dose distribution has been one of the crucial steps in recent treatment planning developments. Plan evaluation and optimization have been based on the physical dose distribution and dose-volume parameters for several decades. However, with the development of a. clinical radiobiology in both domains of tumor and normal tissue response to radiation, ii) existence of reliable clinical results, and b. emergence of new mathematical models in cancer biology and treatment, radiation scientists have been motivated to calculate tumor control probability (TCP) and normal tissue complication probability (NTCP) for modern complex clinical treatment plans. The prediction of clinical outcome in terms of TCP in radiation therapy and its development have been an interesting subject of investigations for several decades. Additionally, this process has provided new information on radiotherapy consequences such as increased local control rates and lower complications rates. It also has helped treatment teams to choose optimum plans for individual patients. In this overview, we will look into some of these studies and give emphasis on potential benefits of TCP/NTCP calculations in different areas of radiation therapy such as plan evaluation, and the uncertainties associated with dose delivery. Keywords: Radiation therapy; Treatment planning; Radiobiological modelling;Tumor control probability; Normal tissue complication probability An Overview on the Clinical Application of Radiobiological Modeling in Radiation Therapy of Cancer 2/7Copyright: ©2017 Mesbahi et al.The β i parameter denotes the repairable part of radiation damage which varies over the population of patients. Also i g shows the fraction of patients having as their radiosensitivity [4].There are several models for NTCP calculations using DVH, dosimetric data of each patient. [4] One of the most applied models is the Lyman-Kutcher-Burman (LKB) model [1]. The NTCP calculation in the LKB model is defined as:Where TD 50 (v) is the tolerance dose for a 50% complication probability caused by uniform irradiation to volume v, and where n is the volume exponent and m is a parameter that is inversely related to the steepness of the dose-response curve.The increasing number of publications on radiobiological modeling implies its progressive utilization in current clinical practice as well as in silico (computer) modelling research. Although, the main purpose of TCP/NTCP calculations has been to provide a surrogate tool for plan comparisons and optimum plan selection for a given treatment, there are many other investigations that have employed this approach to quantize the radiobiological consequences for different available modalities, and geometric errors, as well as comparing novel techniques for radiation therapy [2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Moreover, several studies have ut...

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IMRT boost dose planning on dominant intraprostatic lesions: Gold marker-based three-dimensional fusion of CT with dynamic contrast-enhanced and 1H-spectroscopic MRI

Cited by 162 publications

References 50 publications

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

Intensity-Modulated Radiotherapy of Pelvic Lymph Nodes in Locally Advanced Prostate Cancer: Planning Procedures and Early Experiences

On the impact of functional imaging accuracy on selective boosting IMRT

An Overview on the Clinical Application of Radiobiological Modeling in Radiation Therapy of Cancer

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