TY - JOUR
T1 - Eine Durchführbarkeitsstudie zur Dosimetrie bei Prostatakarzinom
T2 - Sind wir bereit für eine multizentrische klinische Studie über SBRT?
AU - Marino, Carmelo
AU - Villaggi, Elena
AU - Maggi, Giulia
AU - Esposito, Marco
AU - Strigari, Lidia
AU - Bonanno, Elisa
AU - Borzì, Giusi R.
AU - Carbonini, Claudia
AU - Consorti, Rita
AU - Fedele, David
AU - Fiandra, Christian
AU - Ielo, Isidora
AU - Malatesta, Tiziana
AU - Malisan, Maria Rosa
AU - Martinotti, Anna
AU - Moretti, Renzo
AU - Nardiello, Barbara
AU - Oliviero, Caterina
AU - Clemente, Stefania
AU - Mancosu, Pietro
PY - 2015/3/8
Y1 - 2015/3/8
N2 - Purpose: The Italian Association of Medical Physics (AIFM) started a working group dedicated to stereotactic body radiotherapy (SBRT) treatment. In this work, we performed a multicenter planning study on patients who were candidates for SBRT in the treatment of prostate cancer with the aim of evaluating the dosimetric consistency among the different hospitals. Methods and materials: Fourteen centers were provided the contours of 5 patients. Plans were performed following the dose prescription and constraints for organs at risk (OARs) of a reference paper. The dose prescription was 35 Gy in five fractions for the planning target volume (PTV). Different techniques were used (3D-CRT, fixed-Field IMRT, VMAT, CyberKnife). Plans were compared in terms of dose–volume histogram (DVH) parameters. Furthermore, the median DVH was calculated and one patient was re-planned. Results: A total of 70 plans were compared. The maximum dose to the body was 107.9 ± 4.5 % (range 101.5–116.3 %). Dose at 98 % (D98 %) and mean dose to the clinical target volume (CTV) were 102.0 ± 0.9 % (global range 101.1–102.9 %) and 105.1 ± 0.6 % (range 98.6–124.6 %). Similar trends were found for D95 % and mean dose to the PTV. Important differences were found in terms of the homogeneity index. Doses to OARs were heterogeneous. The subgroups with the same treatment planning system showed differences comparable to the differences of the whole group. In the re-optimized plans, DVH differences among institutes were reduced and OAR sparing improved. Conclusion: Important dosimetric differences with possible clinical implications, in particular related to OARs, were found. Replanning allowed a reduction in the OAR dose and decreased standard deviations. Multicenter clinical trials on SBRT should require a preplanning study to standardize the optimization procedure.
AB - Purpose: The Italian Association of Medical Physics (AIFM) started a working group dedicated to stereotactic body radiotherapy (SBRT) treatment. In this work, we performed a multicenter planning study on patients who were candidates for SBRT in the treatment of prostate cancer with the aim of evaluating the dosimetric consistency among the different hospitals. Methods and materials: Fourteen centers were provided the contours of 5 patients. Plans were performed following the dose prescription and constraints for organs at risk (OARs) of a reference paper. The dose prescription was 35 Gy in five fractions for the planning target volume (PTV). Different techniques were used (3D-CRT, fixed-Field IMRT, VMAT, CyberKnife). Plans were compared in terms of dose–volume histogram (DVH) parameters. Furthermore, the median DVH was calculated and one patient was re-planned. Results: A total of 70 plans were compared. The maximum dose to the body was 107.9 ± 4.5 % (range 101.5–116.3 %). Dose at 98 % (D98 %) and mean dose to the clinical target volume (CTV) were 102.0 ± 0.9 % (global range 101.1–102.9 %) and 105.1 ± 0.6 % (range 98.6–124.6 %). Similar trends were found for D95 % and mean dose to the PTV. Important differences were found in terms of the homogeneity index. Doses to OARs were heterogeneous. The subgroups with the same treatment planning system showed differences comparable to the differences of the whole group. In the re-optimized plans, DVH differences among institutes were reduced and OAR sparing improved. Conclusion: Important dosimetric differences with possible clinical implications, in particular related to OARs, were found. Replanning allowed a reduction in the OAR dose and decreased standard deviations. Multicenter clinical trials on SBRT should require a preplanning study to standardize the optimization procedure.
KW - Dosimetry, radiation
KW - Multicenter study
KW - Prostate neoplasms
KW - Stereotactic ablative radiotherapy
KW - Stereotactic body radiation therapy
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UR - http://www.scopus.com/inward/citedby.url?scp=84933182511&partnerID=8YFLogxK
U2 - 10.1007/s00066-015-0822-6
DO - 10.1007/s00066-015-0822-6
M3 - Articolo
C2 - 25747263
AN - SCOPUS:84933182511
VL - 191
SP - 573
EP - 581
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
SN - 0179-7158
IS - 7
ER -