Feasibility of dominant intraprostatic lesion boosting using advanced photon-, proton- or brachytherapy

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Piotr AndrzejewskiDietmar Georg

Abstract

Advancements in imaging and dose delivery enable boosting of the dominant intraprostatic lesions (DIL), while maintaining organs-at-risk (OAR) tolerances. This study aimed to assess the feasibility of DIL boosting for volumetric modulated arc therapy (VMAT), intensity modulated proton therapy (IMPT) and high dose rate brachytherapy (HDR-BT). DILs were defined on multiparametric magnetic resonance imaging and fused with planning CT for twelve patients. VMAT, IMPT and HDR-BT plans were created for each patient with an EQD2(α/β) DIL aimed at 111.6 Gy, PTV(initial) D(pres) was 80.9 Gy (EBRT) with CTV D90%=81.9 Gy (HDR-BT). Hard dose constraints were applied for OARs. Higher boost doses were achieved with IMPT compared to VMAT, keeping major OAR doses at similar levels. Patient averaged EQD2(α/β) D50% to DIL were 110.7, 114.2 and 150.1 Gy(IsoE) for VMAT, IMPT and HDR-BT, respectively. Respective rectal wall D(mean) were 30.5±5.0, 16.7±3.6, 9.5±2.5 Gy(IsoE) and bladder wall D(mean) were 21.0±5.5, 15.6±4.3 and 6.3±2.2 Gy(IsoE). DIL boosting was found to be feasible with all investigated techniques. Although OAR doses were higher than for standard treatment approach, the risk levels were reasonably low. HDR-BT was superior to VMAT and ...Continue Reading

Associated Clinical Trials

Jun 20, 2018·William Barrett

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Citations

Feb 24, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Alfonso Gomez-IturriagaJuanita Crook
May 11, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Nora SundahlValérie Fonteyne
Nov 28, 2018·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·M DanielP Baltzer
Jul 21, 2021·Acta Oncologica·Maryam MoteabbedJason A Efstathiou
Sep 25, 2021·The British Journal of Radiology·Yao-Yu Wu, Kang-Hsing Fan
Nov 2, 2021·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Tibor MajorZoltán Takácsi-Nagy

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