Intensity-modulated radiotherapy for whole pelvis irradiation in prostate cancer: A dosimetric and plan robustness study between photons and protons

Ong, Ashley Li Kuan; Ang, Khong Wei; Master, Zubin; Wong, Sandra; Tuan, Jeffrey

doi:10.1016/j.tipsro.2018.02.001

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…This may be because ArcCHECK is cylindrical for the phantom, the subfield in VMAT is smaller, and the angle difference of probe dose response is smaller, which makes it more suitable for the measurement of VMAT plan. [18,22,23] In conclusion, under the condition that the prescription dose covered at least 95% of the PTV standard, whether using IMRT or VMAT technology in simultaneous integrated boost radiotherapy for prostate cancer can satisfy the need of OAR and have a good dose verification pass rate. Compared with the IMRT plan, VMAT plan can reduce the treatment time significantly and improve the treatment effectively; 2ARC plan has similar target coverage, but the protection of bladder, rectum and small bowel is worse; the less the number of VMAT arcs, the worse the OAR protection.…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Dosimetric comparison of fixed field dynamic IMRT and VMAT techniques in simultaneous integrated boost radiotherapy of prostate cancer

Sun

Wang²,

Huang³

et al. 2022

Medicine

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High-risk prostate cancer can take advantage of the combination of hypofractionated radiotherapy and pelvic conventional fraction radiotherapy. The comparison between fixed field dynamic IMRT and VMAT techniques can provide suggestions for clinical treatment. We selected 10 high-risk prostate cancer patients who received radiotherapy at the cancer center of Sun Yat-sen University from January 2016 to December 2019. The targets contained in prostate, seminal vesicles and pelvic lymph nodes. With the same prescription and optimized parameters, 9F, single-arc (1ARC) and double-arc (2ARC) treatment plans were developed. The dose distribution of the targets, OAR, MU, treatment time and gamma pass ratios of dose verification was compared. The D2% (69.37 ± 0.89) Gy, D50% (66.92 ± 0.63) Gy, HI (0.09 ± 0.02), and CI (0.83 ± 0.05) of PTV1 in 9F were slightly better than those of 1ARC which were (71.13 ± 1.21) Gy, (68.50 ± 0.76) Gy, (0.12 ± 0.02), (0.74 ± 0.07), except D98%, the difference was significant (P < .05). All dosimetry indices of PTV1 in 9F and 2ARC were close and have no significant differences (P > .05). The V95% (99.45 ± 0.78)% of PTV2 in 9F was slightly better than that in 1ARC (99.35 ± 1.28)%. The difference was significant (P < .05). All dosimetry indices of PTV2 in 9F and 2ARC were close and the difference was not significant (P > .05). The Dmean of the bladder and the V67.5 Gy of rectum between all three plans were similar. The Dmean of left and right femoral in 1ARC and 2ARC were lower than that in 9F, and the difference was significant (P < .05). Other dosimetry indices of OARs in 9F were lower than those in 1ARC and 2ARC, and much lower than 1ARC. The difference was significant (P < .05). Mean monitor units in 1ARC and 2ARC were fewer by 70.0% and 67.2% in comparison with 9F. The treatment mean time in 1ARC and 2ARC was shorter by 81.7% and 61% in comparison with 9F. Verification pass ratios of γ (3%/3 mm) were 97.8% (9F), 98.9% (1ARC) and 99.4% (2ARC) respectively. The difference was significant (P < .05). Compared with IMRT, VMAT improved delivery efficiency noticeably. Two arcs provided comparable tumor dosimetry coverage, but performed worse in dose sparing for bladder, rectum and small bowel. The IMRT plan was preferable to VMAT in prostate cancer simultaneous integrated boost radiotherapy.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of fixed field dynamic IMRT and VMAT techniques in simultaneous integrated boost radiotherapy of prostate cancer

Sun

Wang²,

Huang³

et al. 2022

Medicine

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show abstract

“…Planning studies showed that intensitymodulated proton therapy significantly reduced the dose to the bladder, small bowel, large bowel, and rectum compared with volumetric arc therapy. 60,61 A reduction of the small bowel volume from 20 Gy to 50 Gy is predictive for the development of bowel toxic effects. 14,50,51 A registry study which included patients treated with pelvic proton therapy showed that intestinal and urinary toxic effects were infrequent after a short follow-up of 14 months.…”

Section: Interpretation Of Trial Resultsmentioning

confidence: 99%

Elective nodal radiotherapy in prostate cancer

Meerleer

Berghen

Briganti

et al. 2021

The Lancet Oncology

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“…In addition, the threedimensional dose validation results of three groups plans in this study meet the clinical requirements (γ ≥ 90%). Although VMAT plan is more complex than IMRT plan and involves more parameters (collimator angle, multi-leaf grating, dose rate, gantry rotation speed) in the process of treatment implementation, the measurement results of VMAT plan are better than IMRT, which may be because Arccheck is cylindrical for the phantom, the subfield in VMAT is smaller, and the angle difference of probe dose response is smaller, which makes it more suitable for the measurement of VMAT plan [23][24].…”

Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of fixed field dynamic IMRT and VMAT techniques in simultaneous integrated boost radiotherapy of Prostate Cancer

Sun

Liu

Chen

et al. 2020

Preprint

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Background: As the high risk prostate cancer can be benefited from the combination of hypo-fractionated radiotherapy and pelvic conventional fraction radiotherapy, the comparison between fixed field dynamic IMRT and VMAT techniques can provide suggestion for clinical treatment. Methods: We selected 10 patients with high risk prostate cancer who received radiotherapy at Sun Yat-sen University Cancer Center from 2013 January to 2013 December. The target including the prostate, seminal vesicle and pelvic lymph nodes. With the same prescription and optimized parameters, 9 field IMRT, single arc and double arc VMAT treatment plans were designed, which are expressed by 9F, 1ARC and 2ARC respectively. The dose distribution of the targets, organs at risk (OAR), monitor units (MUs), treatment time and gamma pass ratios of dose verification were compared. Results: The D2%(69.37±0.89)Gy,D50%(66.92±0.63)Gy, HI(0.09±0.02) and CI(0.83±0.05) of PTV1 in 9F were slightly better than those of 1ARC which were (71.13±1.21) Gy, (68.50±0.76)Gy, (0.12±0.02), (0.74±0.07), except D98% , the difference were significant(p<0.05). All dosimetric indices of PTV1 in 9F and 2ARC were close and has no significant differences (p>0.05). The V95 %(99.45±0.78)% of PTV2 in 9F was slightly better than that in 1ARC (99.35±1.28)%, the difference was significant (p<0.05). All dosimetric indices of PTV2in 9F and 2ARC were close and the difference were no significant (p>0.05). The Dmean of bladder and the V67.5Gyof rectum between all three plans were similarity The Dmean of left and right femoral in 1ARC and 2ARC were lower than that in 9F, and the difference was significant (p<0.05). Other dosimetric indices of OARs in 9F were lower than those in 1ARC and 2ARC, and much lower than 1ARC, the difference were significant (p<0.05). The mean monitor units in 1ARC and 2ARC were fewer by 70.0% and 67.2% in comparison with 9F. The treatment mean time in 1ARC and 2ARC were shorter by 81.7% and 61% in comparison with 9F. The verification pass ratios of γ(3%/3mm)were 97.8% (9F), 98.9% (1ARC) and 99.4% (2ARC) respectively, the difference were significant(p<0.05). Conclusion: Compared with IMRT, VMAT improved delivery efficiency noticeably. Two arcs provided comparable tumor dosimetric coverage, but performed worse in dose sparing for bladder, rectum and small bowel. IMRT plan was better than VMAT in prostate cancer simultaneous integrated boost radiotherapy.

show abstract

Intensity-modulated radiotherapy for whole pelvis irradiation in prostate cancer: A dosimetric and plan robustness study between photons and protons

Cited by 9 publications

References 33 publications

Dosimetric comparison of fixed field dynamic IMRT and VMAT techniques in simultaneous integrated boost radiotherapy of prostate cancer

Dosimetric comparison of fixed field dynamic IMRT and VMAT techniques in simultaneous integrated boost radiotherapy of prostate cancer

Elective nodal radiotherapy in prostate cancer

Dosimetric comparison of fixed field dynamic IMRT and VMAT techniques in simultaneous integrated boost radiotherapy of Prostate Cancer

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