Helical tomotherapy and intensity modulated proton therapy in the treatment of dominant intraprostatic lesion

A treament planning comparison

Francesco Fellin, Raffaella Azzeroni, Angelo Maggio, Stefano Lorentini, Cesare Cozzarini, Nadia Di Muzio, Claudio Fiorino, Riccardo Calandrino, Marco Schwarz

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose To compare helical tomotherapy (HT) and intensity modulated proton therapy (IMPT) for prostate cancer irradiation while concomitantly boosting dominant intraprostatic lesions (DILs). Methods and materials Treatment plans of seven patients were designed for HT and IMPT (pencil beam size: 3 mm sigma). The prescribed median PTV/DIL doses were 71.4/100 Gy in 28 fractions, while satisfying "safe" dose constraints for organs at risks (OARs) including rectum, bladder, femoral heads, penile bulb and urethra. The planner could further reduce the dose to OARs if PTV/DIL constraints were reached. Results IMPT achieved better dose conformity (CI = 1.11 vs 1.31, p <0.05) and coverage (V95% = 97.3% vs 95.3%, p <0.05) in PTV. Concerning DIL volumes, both techniques delivered the prescribed dose (Dmedian: HT = 100 Gy, IMPT = 102.1 Gy) with similar dose conformity (CI: HT = 1.49, IMPT = 1.44) and same dose homogeneity, D99%, D1%, while satisfying the OARs constraints. Excepting urethra, the sparing of OARs was significantly better with IMPT; in general, the lower the dose, the greater the benefit of IMPT. Normal tissue complication probabilities for the rectum were in favor of IMPT with an absolute reduction of 3-8%, depending on the NTCP model (p <0.05). Conclusions Both techniques allowed delivering 100 Gy to DILs, while complying with the OARs constraints. IMPT was superior in sparing OARs for doses up to approximately 70 Gy, with larger benefit at lower doses.

Original languageEnglish
Pages (from-to)207-212
Number of pages6
JournalRadiotherapy and Oncology
Volume107
Issue number2
DOIs
Publication statusPublished - May 2013

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Proton Therapy
Intensity-Modulated Radiotherapy
Organs at Risk
Therapeutics
Urethra
Rectum
Thigh
Prostatic Neoplasms
Urinary Bladder

Keywords

  • IMRT
  • Prostate radiotherapy
  • Protons
  • Tomotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Helical tomotherapy and intensity modulated proton therapy in the treatment of dominant intraprostatic lesion : A treament planning comparison. / Fellin, Francesco; Azzeroni, Raffaella; Maggio, Angelo; Lorentini, Stefano; Cozzarini, Cesare; Di Muzio, Nadia; Fiorino, Claudio; Calandrino, Riccardo; Schwarz, Marco.

In: Radiotherapy and Oncology, Vol. 107, No. 2, 05.2013, p. 207-212.

Research output: Contribution to journalArticle

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abstract = "Purpose To compare helical tomotherapy (HT) and intensity modulated proton therapy (IMPT) for prostate cancer irradiation while concomitantly boosting dominant intraprostatic lesions (DILs). Methods and materials Treatment plans of seven patients were designed for HT and IMPT (pencil beam size: 3 mm sigma). The prescribed median PTV/DIL doses were 71.4/100 Gy in 28 fractions, while satisfying {"}safe{"} dose constraints for organs at risks (OARs) including rectum, bladder, femoral heads, penile bulb and urethra. The planner could further reduce the dose to OARs if PTV/DIL constraints were reached. Results IMPT achieved better dose conformity (CI = 1.11 vs 1.31, p <0.05) and coverage (V95{\%} = 97.3{\%} vs 95.3{\%}, p <0.05) in PTV. Concerning DIL volumes, both techniques delivered the prescribed dose (Dmedian: HT = 100 Gy, IMPT = 102.1 Gy) with similar dose conformity (CI: HT = 1.49, IMPT = 1.44) and same dose homogeneity, D99{\%}, D1{\%}, while satisfying the OARs constraints. Excepting urethra, the sparing of OARs was significantly better with IMPT; in general, the lower the dose, the greater the benefit of IMPT. Normal tissue complication probabilities for the rectum were in favor of IMPT with an absolute reduction of 3-8{\%}, depending on the NTCP model (p <0.05). Conclusions Both techniques allowed delivering 100 Gy to DILs, while complying with the OARs constraints. IMPT was superior in sparing OARs for doses up to approximately 70 Gy, with larger benefit at lower doses.",
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AU - Fellin, Francesco

AU - Azzeroni, Raffaella

AU - Maggio, Angelo

AU - Lorentini, Stefano

AU - Cozzarini, Cesare

AU - Di Muzio, Nadia

AU - Fiorino, Claudio

AU - Calandrino, Riccardo

AU - Schwarz, Marco

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N2 - Purpose To compare helical tomotherapy (HT) and intensity modulated proton therapy (IMPT) for prostate cancer irradiation while concomitantly boosting dominant intraprostatic lesions (DILs). Methods and materials Treatment plans of seven patients were designed for HT and IMPT (pencil beam size: 3 mm sigma). The prescribed median PTV/DIL doses were 71.4/100 Gy in 28 fractions, while satisfying "safe" dose constraints for organs at risks (OARs) including rectum, bladder, femoral heads, penile bulb and urethra. The planner could further reduce the dose to OARs if PTV/DIL constraints were reached. Results IMPT achieved better dose conformity (CI = 1.11 vs 1.31, p <0.05) and coverage (V95% = 97.3% vs 95.3%, p <0.05) in PTV. Concerning DIL volumes, both techniques delivered the prescribed dose (Dmedian: HT = 100 Gy, IMPT = 102.1 Gy) with similar dose conformity (CI: HT = 1.49, IMPT = 1.44) and same dose homogeneity, D99%, D1%, while satisfying the OARs constraints. Excepting urethra, the sparing of OARs was significantly better with IMPT; in general, the lower the dose, the greater the benefit of IMPT. Normal tissue complication probabilities for the rectum were in favor of IMPT with an absolute reduction of 3-8%, depending on the NTCP model (p <0.05). Conclusions Both techniques allowed delivering 100 Gy to DILs, while complying with the OARs constraints. IMPT was superior in sparing OARs for doses up to approximately 70 Gy, with larger benefit at lower doses.

AB - Purpose To compare helical tomotherapy (HT) and intensity modulated proton therapy (IMPT) for prostate cancer irradiation while concomitantly boosting dominant intraprostatic lesions (DILs). Methods and materials Treatment plans of seven patients were designed for HT and IMPT (pencil beam size: 3 mm sigma). The prescribed median PTV/DIL doses were 71.4/100 Gy in 28 fractions, while satisfying "safe" dose constraints for organs at risks (OARs) including rectum, bladder, femoral heads, penile bulb and urethra. The planner could further reduce the dose to OARs if PTV/DIL constraints were reached. Results IMPT achieved better dose conformity (CI = 1.11 vs 1.31, p <0.05) and coverage (V95% = 97.3% vs 95.3%, p <0.05) in PTV. Concerning DIL volumes, both techniques delivered the prescribed dose (Dmedian: HT = 100 Gy, IMPT = 102.1 Gy) with similar dose conformity (CI: HT = 1.49, IMPT = 1.44) and same dose homogeneity, D99%, D1%, while satisfying the OARs constraints. Excepting urethra, the sparing of OARs was significantly better with IMPT; in general, the lower the dose, the greater the benefit of IMPT. Normal tissue complication probabilities for the rectum were in favor of IMPT with an absolute reduction of 3-8%, depending on the NTCP model (p <0.05). Conclusions Both techniques allowed delivering 100 Gy to DILs, while complying with the OARs constraints. IMPT was superior in sparing OARs for doses up to approximately 70 Gy, with larger benefit at lower doses.

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KW - Prostate radiotherapy

KW - Protons

KW - Tomotherapy

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