BACKGROUND: Three radiotherapy treatment planning (RTTP) protocols for definitive external-beam radiation for localized prostate cancer, designed and clinically applied at Kyoto University, were compared. METHODS: Treatment plans were created according to three different RTTP protocols (old three-dimensional conformal radiotherapy [3D-CRT], new 3D-CRT, and intensity-modulated radiotherapy [IMRT]) on computed tomography (CT) data sets of five patients with localized prostate cancer. The dynamic-arc conformal technique was used in the 3D-CRT protocols. Differences in dose distribution were evaluated and compared based on dose-volume histogram (DVH) analyses. RESULTS: The coverage of the clinical target volume (= prostate alone) was comparable among the three RTTP protocols. However, the average values for the percent volume that received at least 95% of the prescription dose (V95), the percent of the prescription dose covering 95% of the volume (D95), and the conformity index of the planning target volume (PTV) were 99%, 97%, and 0.88 for the IMRT; 93.9%, 94.5%, and 0.76 for the new 3D-CRT; and 59.6%, 82.9%, and 0.6 for the old 3D-CRT protocol, respectively. Inhomogeneity of doses to the PTV was larger with the IMRT protocol than with the new 3D-CRT protocol. Doses to both the rectal wall and bladder wall were almost comparable with the new 3D-CRT and IMRT protocols, but were lower with the old 3D-CRT protocol, due to the lowest prescription dose and incomplete dose coverage of the PTV. CONCLUSION: The old 3D-CRT protocol could not achieve the goals for the PTV set in the IMRT protocol. The new 3D-CRT and IMRT protocols were generally comparable in terms of both the PTV coverage and normal tissue-sparing, although the IMRT protocol achieved the most conformal dose distribution to the PTV, in return for a larger, but acceptable, dose inhomogeneity.
BACKGROUND: Three radiotherapy treatment planning (RTTP) protocols for definitive external-beam radiation for localized prostate cancer, designed and clinically applied at Kyoto University, were compared. METHODS: Treatment plans were created according to three different RTTP protocols (old three-dimensional conformal radiotherapy [3D-CRT], new 3D-CRT, and intensity-modulated radiotherapy [IMRT]) on computed tomography (CT) data sets of five patients with localized prostate cancer. The dynamic-arc conformal technique was used in the 3D-CRT protocols. Differences in dose distribution were evaluated and compared based on dose-volume histogram (DVH) analyses. RESULTS: The coverage of the clinical target volume (= prostate alone) was comparable among the three RTTP protocols. However, the average values for the percent volume that received at least 95% of the prescription dose (V95), the percent of the prescription dose covering 95% of the volume (D95), and the conformity index of the planning target volume (PTV) were 99%, 97%, and 0.88 for the IMRT; 93.9%, 94.5%, and 0.76 for the new 3D-CRT; and 59.6%, 82.9%, and 0.6 for the old 3D-CRT protocol, respectively. Inhomogeneity of doses to the PTV was larger with the IMRT protocol than with the new 3D-CRT protocol. Doses to both the rectal wall and bladder wall were almost comparable with the new 3D-CRT and IMRT protocols, but were lower with the old 3D-CRT protocol, due to the lowest prescription dose and incomplete dose coverage of the PTV. CONCLUSION: The old 3D-CRT protocol could not achieve the goals for the PTV set in the IMRT protocol. The new 3D-CRT and IMRT protocols were generally comparable in terms of both the PTV coverage and normal tissue-sparing, although the IMRT protocol achieved the most conformal dose distribution to the PTV, in return for a larger, but acceptable, dose inhomogeneity.
Authors: M J Zelefsky; D Cowen; Z Fuks; M Shike; C Burman; A Jackson; E S Venkatramen; S A Leibel Journal: Cancer Date: 1999-06-01 Impact factor: 6.860
Authors: M J Zelefsky; Z Fuks; L Happersett; H J Lee; C C Ling; C M Burman; M Hunt; T Wolfe; E S Venkatraman; A Jackson; M Skwarchuk; S A Leibel Journal: Radiother Oncol Date: 2000-06 Impact factor: 6.280
Authors: G E Hanks; T E Schultheiss; A L Hanlon; M Hunt; W R Lee; B E Epstein; L R Coia Journal: Int J Radiat Oncol Biol Phys Date: 1997-02-01 Impact factor: 7.038
Authors: C Burman; C S Chui; G Kutcher; S Leibel; M Zelefsky; T LoSasso; S Spirou; Q Wu; J Yang; J Stein; R Mohan; Z Fuks; C C Ling Journal: Int J Radiat Oncol Biol Phys Date: 1997-11-01 Impact factor: 7.038
Authors: M J Zelefsky; S A Leibel; P B Gaudin; G J Kutcher; N E Fleshner; E S Venkatramen; V E Reuter; W R Fair; C C Ling; Z Fuks Journal: Int J Radiat Oncol Biol Phys Date: 1998-06-01 Impact factor: 7.038
Authors: Alexei Trofimov; Paul L Nguyen; John J Coen; Karen P Doppke; Robert J Schneider; Judith A Adams; Thomas R Bortfeld; Anthony L Zietman; Thomas F Delaney; William U Shipley Journal: Int J Radiat Oncol Biol Phys Date: 2007-05-21 Impact factor: 7.038