Intensity modulated radiotherapy for localized prostate cancer: rigid compliance to dose-volume constraints as a warranty of acceptable toxicity?

Chen, Michael; Weltman, Eduardo; Hanriot, Rodrigo de Morais; Luz, Fábio Prado; Cecilio, Paulo José; Cruz, José C.; Moreira, Frederico Rafael; Santos, Adriana da Silva; Martins, Lidiane C; Nadalin, Wladimir

doi:10.1186/1748-717x-2-6

Cited by 17 publications

(8 citation statements)

References 21 publications

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“…Following treatment, patients may often experience side effects including but not limited to urinary incontinence, diarrhoea, and rectal discomfort. Urinary problems can persist or present at longer time periods following initial treatment, as well as erectile dysfunction [ 62 , 63 ]. In addition, and most worryingly, a third of patients experience radiorecurrent disease [ 64 ].…”

Section: Approaches To Focal Therapy Of Localized Prostate Cancermentioning

confidence: 99%

Low Temperature Plasma: A Novel Focal Therapy for Localized Prostate Cancer?

Hirst

Frame

Maitland

et al. 2014

BioMed Research International

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Despite considerable advances in recent years for the focal treatment of localized prostate cancer, high recurrence rates and detrimental side effects are still a cause for concern. In this review, we compare current focal therapies to a potentially novel approach for the treatment of early onset prostate cancer: low temperature plasma. The rapidly evolving plasma technology has the potential to deliver a wide range of promising medical applications via the delivery of plasma-induced reactive oxygen and nitrogen species. Studies assessing the effect of low temperature plasma on cell lines and xenografts have demonstrated DNA damage leading to apoptosis and reduction in cell viability. However, there have been no studies on prostate cancer, which is an obvious candidate for this novel therapy. We present here the potential of low temperature plasma as a focal therapy for prostate cancer.

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Section: Approaches To Focal Therapy Of Localized Prostate Cancermentioning

confidence: 99%

Low Temperature Plasma: A Novel Focal Therapy for Localized Prostate Cancer?

Hirst

Frame

Maitland

et al. 2014

BioMed Research International

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“…This may be due to inherent radio-resistance of a small fraction of the tumour – the cancer stem-like cells ( Frame et al , 2013 ). Furthermore, numerous side effects are often experienced following treatment ( Chen et al , 2007 ; Lips et al , 2008 ), even with more recent technological developments, such as stereotactic body radiation therapy (Cyberknife) ( Woo et al , 2014 ).…”

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confidence: 99%

Low-temperature plasma treatment induces DNA damage leading to necrotic cell death in primary prostate epithelial cells

et al. 2015

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Background:In recent years, the rapidly advancing field of low-temperature atmospheric pressure plasmas has shown considerable promise for future translational biomedical applications, including cancer therapy, through the generation of reactive oxygen and nitrogen species.Method:The cytopathic effect of low-temperature plasma was first verified in two commonly used prostate cell lines: BPH-1 and PC-3 cells. The study was then extended to analyse the effects in paired normal and tumour (Gleason grade 7) prostate epithelial cells cultured directly from patient tissue. Hydrogen peroxide (H2O2) and staurosporine were used as controls throughout.Results:Low-temperature plasma (LTP) exposure resulted in high levels of DNA damage, a reduction in cell viability, and colony-forming ability. H2O2 formed in the culture medium was a likely facilitator of these effects. Necrosis and autophagy were recorded in primary cells, whereas cell lines exhibited apoptosis and necrosis.Conclusions:This study demonstrates that LTP treatment causes cytotoxic insult in primary prostate cells, leading to rapid necrotic cell death. It also highlights the need to study primary cultures in order to gain more realistic insight into patient response.

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“…The Department of Radiation Oncology of the University Hospital of the LMU Munich has ongoing research agreements with Elekta Inc., Brainlab GmbH and ViewRay Inc. Physics, Faculty of Physics, Ludwig-Maximilians-Universitä München, Garching, Germany. 3 German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Planegg, Germany. 4 German Cancer Consortium (DKTK), Munich, Germany.…”

Section: Ethics Approval and Consent To Participatementioning

confidence: 99%

“…The anatomical structure of the male pelvic region with prostate, surrounded by seminal vesicles, bladder, and rectum, makes intensity-modulated radiation therapy (IMRT) a favorable technique for the treatment of localized prostate cancer [1][2][3]. However, due to variable bladder and rectal filling, random shifts, and deformations of neighboring organs, online adaptation of the treatment plan would be necessary in order to take full advantage of modern radiotherapy techniques.…”

Section: Introductionmentioning

confidence: 99%

Dosimetric Impact of Deep Learning-Based CT Auto-Segmentation on IMRT Treatment Planning for Prostate Cancer

Kawula

Purice²,

Li³

et al. 2021

Preprint

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Background The evaluation of the automatic segmentation algorithms is commonly performed using geometric metrics, yet an evaluation based on dosimetric parameters might be more relevant in clinical practice but is still lacking in the literature. The aim of this study was to investigate the impact of state-of-the-art 3D U-Net-generated organ delineations on dose optimization in intensity-modulated radiation therapy (IMRT) for prostate patients for the first time. Methods A database of 69 computed tomography (CT) images with prostate, bladder, and rectum delineations was used for single-label 3D U-Net training with dice similarity coefficient (DSC)-based loss. Volumetric modulated arc therapy (VMAT) plans have been generated for both manual and automatic segmentations with the same optimization settings. These were chosen to give consistent plans when applying perturbations to the manual segmentations. Contours were evaluated in terms of DSC, average and 95% Hausdorff distance (HD). Dose distributions were evaluated with the manual segmentation as reference using dose volume histogram (DVH) parameters and a 3%/3mm gamma-criterion with 10% dose cut-off. A Pearson correlation coefficient between DSC and dosimetric metrics, gamma index and DVH parameters, has been calculated. Results 3D U-Net based segmentation achieved a DSC of 0.87(0.03) for prostate, 0.97(0.01) for bladder and 0.89(0.04) for rectum. The mean and 95% HD were below 1.6(0.4) and below 5(4) mm, respectively. The DVH parameters V 60/65/70 Gy for the bladder and V 50/65/70 Gy for the rectum showed agreement between dose distributions within ±5% and ±2%, respectively. The DVH parameters for prostate and prostate+3mm margin (surrogate clinical target volume) showed good target coverage for the 3D U-Net segmentation with the exception of one case. The average gamma pass-rate was 85\%. A comparison between geometric and dosimetric metrics showed no strong statistically significant correlation between these metrics. Conclusions The 3D U-Net developed for this work achieved state-of-the-art geometrical performance. The study highlighted the importance of dosimetric evaluation on top of standard geometric parameters and concluded that the automatic segmentation is sufficiently accurate to assist the physicians in manually contouring organs in CT images of the male pelvic region, which is an important step towards a fully automated workflow in IMRT.

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Intensity modulated radiotherapy for localized prostate cancer: rigid compliance to dose-volume constraints as a warranty of acceptable toxicity?

Abstract: Background: To report the toxicity after intensity modulated radiotherapy (IMRT) for patients with localized prostate cancer, as a sole treatment or after radical prostatectomy.

Cited by 17 publications

References 21 publications

Low Temperature Plasma: A Novel Focal Therapy for Localized Prostate Cancer?

Low Temperature Plasma: A Novel Focal Therapy for Localized Prostate Cancer?

Low-temperature plasma treatment induces DNA damage leading to necrotic cell death in primary prostate epithelial cells

Dosimetric Impact of Deep Learning-Based CT Auto-Segmentation on IMRT Treatment Planning for Prostate Cancer

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