1
|
Kyei KA, Daniels J, Adom AK, Odonkor P, Nyantakyi AY, Adjabu DE. A dosimetric evaluation of intensity modulated radiotherapy and three-dimensional conformal radiotherapy for prostate cancer in Ghana. Ecancermedicalscience 2024; 18:1707. [PMID: 39021534 PMCID: PMC11254402 DOI: 10.3332/ecancer.2024.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Indexed: 07/20/2024] Open
Abstract
External beam radiotherapy incorporates treatment techniques such as three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), image-guided radiotherapy and volumetric modulated arc therapy to deliver high-energy radiation to cancer. The use of IMRT for cancer treatment is also associated with significant costs for patients in low-middle-income countries. The purpose of this study was to compare the dosimetric properties of 3DCRT and IMRT treatment plans for the external beam irradiation of patients with prostate cancer (Pca) to ascertain the superiority of IMRT in terms of dose homogeneity, conformity and dose limitation to organs at risk (OAR) in a resource-limited setting. One hundred and sixty treatment plans for 80 patients were created using 3DCRT and IMRT on the Eclipse treatment planning system (version 13.6). Data were collected and assessed from the dose-volume histogram of each plan. The conformity and homogeneity index (HI) for each of the plans were calculated. The doses to the OAR were also recorded and evaluated. The mean HIs for the IMRT and 3DCRT treatment techniques were 0.04 ± 0.02 (range: 0.01-0.011) and 0.09 ± 0.02 (range: 0.04-0.016), respectively. The mean conformity index (CI) for IMRT and 3DCRT techniques were 1.257 ± 0.112 (range: 0.99-1.58) and 1.302 ± 0.196 (range: 1.10-2.26). IMRT had a better significant mean HI and CI compared to 3DCRT. Generally, for this study, IMRT had better organ sparing compared to 3DCRT. The mean doses for the OARs ranged from 4.3-74.6 Gy for IMRT and 3.1-75.9 Gy for the 3DCRT technique. Overall, this study demonstrates that IMRT may offer an enhanced therapeutic profile, potentially reducing toxicity to the patient and ensuring more precise dose delivery to the target volume compared to 3DCRT in PCa external beam irradiation.
Collapse
Affiliation(s)
- Kofi Adesi Kyei
- Department of Radiography, University of Ghana, Legon, KB 143, Ghana
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, KB 369, Ghana
- https://orcid.org/0000-0003-3485-5368
| | - Joseph Daniels
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, KB 369, Ghana
- https://orcid.org/0000-0002-1466-150X
| | - Ameyaw Kwame Adom
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, KB 369, Ghana
- https://orcid.org/0009-0004-1999-3767
| | - Philip Odonkor
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, KB 369, Ghana
- https://orcid.org/0009-0003-8046-9078
| | - Andrew Yaw Nyantakyi
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, KB 369, Ghana
- https://orcid.org/0000-0003-0742-6007
| | - Dorothy Ekua Adjabu
- Department of Physiotherapy, School of Biomedical and Allied Health, University of Ghana, Accra, KB 143, Ghana
| |
Collapse
|
2
|
Hassan IM, Attalla EM, El-Gohary MI. Impact of 3D conformal and Intensity Modulated Radiotherapy on secondary cancer risk for patients with early prostate cancer. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
3
|
Kang DJ, Shin YJ, Jeong S, Jung JY, Lee H, Lee B. Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy. Radiat Oncol 2021; 16:108. [PMID: 34118968 PMCID: PMC8199704 DOI: 10.1186/s13014-020-01722-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 12/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study is to develop a clinical application program that automatically calculates the effect for secondary cancer risk (SCR) of individual patient. The program was designed based on accurate dose calculations using patient computed tomography (CT) data and Monte Carlo engine. Automated patient-specific evaluation program was configured to calculate SCR. Methods The application program is designed to re-calculate the beam sequence of treatment plan using the Monte Carlo engine and patient CT data, so it is possible to accurately calculate and evaluate scatter and leakage radiation, difficult to calculate in TPS. The Monte Carlo dose calculation system was performed through stoichiometric calibration using patient CT data. The automatic SCR evaluation program in application program created with a MATLAB was set to analyze the results to calculate SCR. The SCR for organ of patient was calculated based on Biological Effects of Ionizing Radiation (BEIR) VII models. The program is designed to sequentially calculate organ equivalent dose (OED), excess absolute risk (EAR), excess relative risk (ERR), and the lifetime attributable risk (LAR) in consideration of 3D dose distribution analysis. In order to confirm the usefulness of the developed clinical application program, the result values from clinical application program were compared with the manual calculation method used in the previous study. Results The OED values calculated in program were calculated to be at most approximately 13.3% higher than results in TPS. The SCR result calculated by the developed clinical application program showed a maximum difference of 1.24% compared to the result of the conventional manual calculation method. And it was confirmed that EAR, ERR and LAR values can be easily calculated by changing the biological parameters. Conclusions We have developed a patient-specific SCR evaluation program that can be used conveniently in the clinic. The program consists of a Monte Carlo dose calculation system for accurate calculation of scatter and leakage radiation and a patient-specific automatic SCR evaluation program using 3D dose distribution. The clinical application program that improved the disadvantages of the existing process can be used as an index for evaluating a patient treatment plan.
Collapse
Affiliation(s)
- Dong-Jin Kang
- Department of Radiation Oncology, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, Korea
| | - Young-Joo Shin
- Department of Radiation Oncology, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, Korea.
| | - Seonghoon Jeong
- Proton Therapy Center, National Cancer Center, Goyang, Korea
| | - Jae-Yong Jung
- Department of Radiation Oncology, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, Korea
| | | | - Boram Lee
- Department of Radiation Oncology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, 81, Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea.
| |
Collapse
|
4
|
Gleeson I. A comparison of a moderately hypofractionated IMRT planning technique used in a randomised UK external beam radiotherapy trial with an in-house technique for localised prostate cancer. Rep Pract Oncol Radiother 2020; 25:360-366. [PMID: 32256220 DOI: 10.1016/j.rpor.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/26/2019] [Accepted: 03/10/2020] [Indexed: 11/18/2022] Open
Abstract
AIM To compare the radiotherapy technique used in a randomised trial with VMAT and an in-house technique for prostate cancer. BACKGROUND Techniques are evolving with volumetric modulated arc therapy (VMAT) commonly used. The CHHiP trial used a 3 PTV forward planned IMRT technique (FP_CH). Our centre has adopted a simpler two PTV technique with locally calculated margins. MATERIALS AND METHODS 25 patients treated with FP_CH to 60 Gy in 20 fractions were re-planned with VMAT (VMAT_CH) and a two PTV protocol (VMAT_60/52 and VMAT_60/48). Target coverage, conformity index (CI), homogeneity index (HI), monitor units (MU) and dose to the rectum, bladder, hips and penile bulb were compared. RESULTS PTV coverage was high for all techniques. VMAT_CH plans had better CI than FP_CH (p ≤ 0.05). VMAT_60/52/48 plans had better CI than VMAT_CH. FP_CH had better HI and fewer MU than VMAT (p ≤ 0.05). More favourable rectum doses were found for VMAT _CH than FP_CH (V48.6, V52.8, V57, p ≤ 0.05) with less difference for bladder (p ≥ 0.05). Comparing VMAT_CH to VMAT_60/52/48 showed little differences for the bladder and rectum but VMAT_CH had larger penile bulb doses (V40.8, V48.6, mean, D2, p ≤ 0.05). Femoral head doses (V40.8) were similarly low for all techniques (p = ≥ 0.05). CONCLUSION VMAT produced more conformal plans with smaller rectum doses compared to FP_CH albeit worse HI and more MU. VMAT_60/52 and VMAT_60/48 plans had similar rectal and bladder doses to VMAT_CH but better CI and penile bulb doses which may reduce toxicity.
Collapse
Affiliation(s)
- Ian Gleeson
- Department of Medical Physics, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| |
Collapse
|
5
|
Mohseni M, Mohaghegh F, Robatmili N, Bayatiani MR, Seif F, Mostafavi NS. Comparison of Photon-electron and Photon Radiotherapy for Supraclavicular Lymph Nodes of Mastectomy Patients with Left-sided Breast Cancer. J Cancer Prev 2020; 25:48-54. [PMID: 32266179 PMCID: PMC7113409 DOI: 10.15430/jcp.2020.25.1.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/20/2022] Open
Abstract
The aim of radiotherapy is to deliver the highest possible radiation dose to the tumor and the lowest radiation to normal tissues surrounding the tumor. In the present study, lymph nodes of the supraclavicular region were treated using two therapeutic techniques, namely photon technique (PT) and combinatory photon-electron technique (CPET). We recruited 50 patients with local lymph node metastasis. The photon energies were 6-15 MV. Furthermore, the electron beam energy was 18 MeV in CPET. The study findings revealed that the mean delivered dose to target volume was 41.12 ± 2.98Gy for PT and 44.56 ± 1.90Gy for CPET. The percentage of the target volume irradiated to 90% of the prescribed dose (V90) was calculated as 74.61% ± 9.30% and 82.06% ± 9.70% for PT and CPET, respectively. The mean dose delivered to the heart and lungs was not significantly different between the two groups. Furthermore, the maximum doses delivered to the spinal cord were 12.55Gy in PT and 8.89Gy in CPET. The mean doses delivered to the thyroid gland were 39.26 and 34.89Gy in PT and CPET. According to the study results, the maximum doses delivered to the spinal cord, head of the humerus bone, and thyroid were reduced significantly as measured the CPET technique. In contrast, no significant difference was observed regarding the dose delivered to the heart and lung. The dose delivered to the supraclavicular region determined by the CPET was significantly augmented. Furthermore, the coverage of the tumor mass was optimized using the new method.
Collapse
Affiliation(s)
- Mehran Mohseni
- Department of Medical Physics, School of Paramedical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatholah Mohaghegh
- Department of Medical Physics and Radiotherapy, Arak University of Medical Sciences and Khansari Hospital, Arak, Iran
| | - Nasrin Robatmili
- Department of Medical Physics, School of Paramedical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Reza Bayatiani
- Department of Medical Physics and Radiotherapy, Arak University of Medical Sciences and Khansari Hospital, Arak, Iran
| | - Fatemeh Seif
- Department of Medical Physics and Radiotherapy, Arak University of Medical Sciences and Khansari Hospital, Arak, Iran
| | - Nayyer Sadat Mostafavi
- Department of Medical Physics, School of Paramedical Sciences, Isfahan University of Medical Sciences and Khansari Hospital, Isfahan, Iran
| |
Collapse
|
6
|
Hatano K, Tohyama N, Kodama T, Okabe N, Sakai M, Konoeda K. Current status of intensity‐modulated radiation therapy for prostate cancer: History, clinical results and future directions. Int J Urol 2019; 26:775-784. [DOI: 10.1111/iju.14011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/07/2019] [Indexed: 01/05/2023]
Affiliation(s)
- Kazuo Hatano
- Division of Radiation Oncology Tokyo‐Bay Advanced Imaging & Radiation Oncology Clinic/Makuhari Chiba Japan
| | - Naoki Tohyama
- Division of Radiation Oncology Tokyo‐Bay Advanced Imaging & Radiation Oncology Clinic/Makuhari Chiba Japan
| | - Takashi Kodama
- Division of Radiation Oncology Tokyo‐Bay Advanced Imaging & Radiation Oncology Clinic/Makuhari Chiba Japan
| | - Naoyuki Okabe
- Division of Radiation Oncology Tokyo‐Bay Advanced Imaging & Radiation Oncology Clinic/Makuhari Chiba Japan
| | - Mitsuhiro Sakai
- Division of Radiation Oncology Tokyo‐Bay Advanced Imaging & Radiation Oncology Clinic/Makuhari Chiba Japan
| | - Koichi Konoeda
- Division of Radiation Oncology Tokyo‐Bay Advanced Imaging & Radiation Oncology Clinic/Makuhari Chiba Japan
| |
Collapse
|
7
|
Zhao S, Xie Q, Yang R, Wang J, Zhang C, Luo L, Zhu Z, Liu Y, Li E, Zhao Z. High prevalence of secondary bladder cancer in men on radiotherapy for prostate cancer: evidence from a meta-analysis. Cancer Manag Res 2019; 11:587-598. [PMID: 30666156 PMCID: PMC6331076 DOI: 10.2147/cmar.s185867] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective To assess whether radiotherapy (RT) for prostate cancer (PCa) was a risk factor for secondary bladder cancer (BLCa) through a meta-analysis. Materials and methods The MEDLINE, Embase, and the Cochrane Library were systematically searched for all studies investigating the risk of BLCa in patients with RT. The association between RT and risk of BLCa was summarized using hazard ratio with a 95%CI. The protocol for this meta-analysis is available from PROSPERO (CRD42018090075). Results Overall, 619,479 participants (age: 57-79 years) were included from 15 studies, 206,852 of whom were patients who received RT. Synthesis of results indicated that RT was significantly associated with an increased risk of BLCa compared with the risk in those who received radical prostatectomy or non-RT (overall HR=1.6, 95%CI: 1.33-1.92, P<0.001). The results were consistent when restricted to a 5-year lag period (HR=1.84, 95%CI: 1.26-2.69, P=0.002) and multivariable adjustment (HR=1.96, 95%CI: 1.47-2.62, P<0.001), but not for 10-year lag period (HR=1.93, 95%CI: 0.9- 4.16, P=0.093) and brachytherapy subgroup (HR=1.33, 95%CI: 0.87-2.05, P=0.188). The GRADE-profiler revealed that the rate of events of BLCa on average in the RT-patients and the non-RT control was 2,462/183,669 (1.3%) and 4,263/382,761(1.1%), respectively; the overall quality of the evidence was low. Conclusion Patients who received RT for PCa was associated with higher risks of developing secondary BLCa compared to those unexposed to RT, but the absolute effect was low.
Collapse
Affiliation(s)
- Shankun Zhao
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| | - Qiang Xie
- Department of Reproduction, Southern Medical University Affiliate Dongguan People's Hospital, Dongguan, China
| | - Redian Yang
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| | - Jiamin Wang
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| | - Chaofeng Zhang
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| | - Lianmin Luo
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| | - Zhiguo Zhu
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| | - Yangzhou Liu
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| | - Ermao Li
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| | - Zhigang Zhao
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China,
| |
Collapse
|
8
|
Maruyama N, Nakasone T, Arakaki O, Matsumoto H, Maruyama T, Matayoshi A, Goto T, Saito S, Yoshimi N, Arasaki A, Nishihara K. Triple primary cancer of the head and neck, skin and prostate: A case report and literature review. Oncol Lett 2018; 16:5249-5256. [PMID: 30250595 PMCID: PMC6144871 DOI: 10.3892/ol.2018.9294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 06/13/2018] [Indexed: 01/17/2023] Open
Abstract
Second primary cancer (SPC) is an important prognostic factor for patients with head and neck cancer (HNC); therefore, the association between the prognosis and development of SPC has been well-reported. The use of 2-[18F]-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) is valuable to examine cancer stage, evaluate treatment responses and investigate suspected relapses or metastases. In the present study, the case of a male patient who was diagnosed with three primary cancer types, including well to moderately differentiated squamous cell carcinoma (SCC) of the mandible, axillary cutaneous poorly differentiated SCC and prostate adenocarcinoma, was described. Among these, mandible cancer was the first diagnosed when the patient was 70 years of age. Synchronous skin and prostate cancer (PRC) types then developed 3 years later. To the best of our knowledge, this is the first report of the aforementioned combination of cancer types. Postoperative FDG-PET was not performed as no lesions of recurrence or metastases of mandible cancer were found. Three years later, the PRC was asymptomatic and was incidentally detected by FDG-PET performed for a preoperative evaluation of skin cancer. It was indicated that FDG-PET could be utilized in patients with HNC due to there being no accurate FDG-PET protocol to detect SPC over a long-term follow-up.
Collapse
Affiliation(s)
- Nobuyuki Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| | - Toshiyuki Nakasone
- Department of Oral and Maxillofacial Surgery, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| | - Osao Arakaki
- Department of Dermatology, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| | - Hirofumi Matsumoto
- Department of Pathology, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| | - Tessho Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| | - Akira Matayoshi
- Department of Oral and Maxillofacial Surgery, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| | - Takahiro Goto
- Department of Oral and Maxillofacial Surgery, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| | - Seiichi Saito
- Department of Urology, Graduate School of Medicine, University of The Ryukyus, Okinawa 903-0215, Japan
| | - Naoki Yoshimi
- Department of Pathology, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
- Department of Pathology and Oncology, Graduate School of Medicine, University of The Ryukyus, Okinawa 903-0215, Japan
| | - Akira Arasaki
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| | - Kazuhide Nishihara
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, University Hospital of The Ryukyus, Okinawa 903-0215, Japan
| |
Collapse
|
9
|
Li MH, Huang SF, Chang CC, Lin JC, Tsai JT. Variations in dosimetric distribution and plan complexity with collimator angles in hypofractionated volumetric arc radiotherapy for treating prostate cancer. J Appl Clin Med Phys 2018; 19:93-102. [PMID: 29322625 PMCID: PMC5849828 DOI: 10.1002/acm2.12249] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/19/2017] [Accepted: 12/05/2017] [Indexed: 11/21/2022] Open
Abstract
Purpose Hypofractionated radiotherapy can reduce treatment durations and produce effects identical to those of conventionally fractionated radiotherapy for treating prostate cancer. Volumetric arc radiotherapy (VMAT) can decrease the treatment machine monitor units (MUs). Previous studies have shown that VMAT with multileaf collimator (MLC) rotation exhibits better target dose distribution. Thus, VMAT with MLC rotation warrants further investigation. Methods and materials Ten patients with prostate cancer were included in this study. The prostate gland and seminal vesicle received 68.75 and 55 Gy, respectively, in 25 fractions. A dual‐arc VMAT plan with a collimator angle of 0° was generated and the same constraints were used to reoptimize VMAT plans with different collimator angles. The conformity index (CI), homogeneity index (HI), gradient index (GI), normalized dose contrast (NDC), MU, and modulation complexity score (MCSV) of the target were analyzed. The dose–volume histogram of the adjacent organs was analyzed. A Wilcoxon signed‐rank test was used to compare different collimator angles. Results Optimum values of CI, HI, and MCSV were obtained with a collimator angle of 45°. The optimum values of GI, and NDC were observed with a collimator angle of 0°. In the rectum, the highest values of maximum dose and volume receiving 60 Gy (V60 Gy) were obtained with a collimator angle of 0°, and the lowest value of mean dose (Dmean) was obtained with a collimator angle of 45°. In the bladder, high values of Dmean were obtained with collimator angles of 75° and 90°. In the rectum and bladder, the values of V60 Gy obtained with the other tested angles were not significantly higher than those obtained with an angle of 0°. Conclusion This study found that MLC rotation affects VMAT plan complexity and dosimetric distribution. A collimator angle of 45° exhibited the optimal values of CI, HI, and MCSv among all the tested collimator angles. Late side effects of the rectum and bladder are associated with high‐dose volumes by previous studies. MLC rotation did not have statistically significantly higher values of V60 Gy in the rectum and bladder than did the 0° angle. We thought a collimator angle of 45° was an optimal angle for the prostate VMAT treatment plan. The findings can serve as a guide for collimator angle selection in prostate hypofractionated VMAT planning.
Collapse
Affiliation(s)
- Ming-Hsien Li
- Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, China
| | - Sheng-Fang Huang
- Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, China
| | - Chih-Chieh Chang
- Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, China
| | - Jang-Chun Lin
- Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, China.,School of Medicine, College of Medicine, Department of Radiology, Taipei Medical University, Taipei, Taiwan, China
| | - Jo-Ting Tsai
- Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, China.,School of Medicine, College of Medicine, Department of Radiology, Taipei Medical University, Taipei, Taiwan, China
| |
Collapse
|
10
|
Chemingui FZ, Benrachi F, Bali MS, Ladjal H. Dosimetric comparison between VMAT and RC3D techniques: case of prostate treatment. EPJ WEB OF CONFERENCES 2017. [DOI: 10.1051/epjconf/201715401013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
11
|
Ren W, Sun C, Lu N, Xu Y, Han F, Liu YP, Dai J. Dosimetric comparison of intensity-modulated radiotherapy and volumetric-modulated arc radiotherapy in patients with prostate cancer: a meta-analysis. J Appl Clin Med Phys 2016; 17:254-262. [PMID: 27929498 PMCID: PMC5690508 DOI: 10.1120/jacmp.v17i6.6464] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 08/13/2016] [Accepted: 08/10/2016] [Indexed: 11/23/2022] Open
Abstract
Intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) are two main radiotherapy techniques. The aim of this study is to explore which is the preferred technique in prostate treatment through the related publica-tions and meta-analysis. Two authors independently identified all relevant articles available regarding eligibility criteria on PubMed, Embase, and Cochrane Library databases until December 2015. Publication bias was evaluated with funnel plot, and statistical analyses were performed with Stata software. P < 0.05 was thought statistically significant. Ten studies comprised a total of 110 patients; in total 110 IMRT plans and 110 VMAT plans that were included in this study. V40, V60, and V70 of rectum were significantly decreased in VMAT than in IMRT. However, V50 of rectum and V40, V50, V60, V70 of bladder had no statistical differences between IMRI and VMAT plans. Compared with IMRT, the treatment time and MUs of VMAT were significantly lower. VMAT protects rectum better than IMRT and improves the delivery efficiency. VMAT may be the preferred modality for treating prostate cancer.
Collapse
Affiliation(s)
- Wenting Ren
- Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College.
| | | | | | | | | | | | | |
Collapse
|