Piotr Andrzejewski1, Peter Kuess2, Barbara Knäusl2, Katja Pinker3, Petra Georg4, Johannes Knoth5, Daniel Berger5, Christian Kirisits2, Gregor Goldner2, Thomas Helbich3, Richard Pötter2, Dietmar Georg2. 1. Dept. of Radiation Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna, Austria. Electronic address: piotr.andrzejewski@meduniwien.ac.at. 2. Dept. of Radiation Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna, Austria. 3. Dept. of Biomedical Imaging and Image-guided Therapy, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna, Austria. 4. Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna, Austria; EBG MedAustron GmbH, Wiener Neustadt, Austria. 5. Dept. of Radiation Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria.
Abstract
BACKGROUND AND PURPOSE: 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). MATERIAL AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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 IMPT, both in terms of OAR sparing and DIL boosting.
BACKGROUND AND PURPOSE: 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). MATERIAL AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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 IMPT, both in terms of OAR sparing and DIL boosting.
Authors: Lucian Beer; Stephan H Polanec; Pascal A T Baltzer; Georg Schatzl; Dietmar Georg; Christian Schestak; Anja Dutschke; Harald Herrmann; Peter Mazal; Alexander K Brendel; Shahrokh F Shariat; Helmut Ringl; Thomas H Helbich; Paul Apfaltrer Journal: PLoS One Date: 2019-12-19 Impact factor: 3.240
Authors: Jesper Pedersen; Oscar Casares-Magaz; Jørgen B B Petersen; Jarle Rørvik; Lise Bentzen; Andreas G Andersen; Ludvig P Muren Journal: Phys Imaging Radiat Oncol Date: 2018-07-18
Authors: Christopher W Smith; Ryan Alfano; Douglas Hoover; Kathleen Surry; David D'Souza; Jonathan Thiessen; Irina Rachinsky; John Butler; Jose A Gomez; Mena Gaed; Madeleine Moussa; Joseph Chin; Stephen Pautler; Glenn S Bauman; Aaron D Ward Journal: Phys Imaging Radiat Oncol Date: 2021-07-30