1. Ultrahypofractionated radiotherapy for localized prostate cancer with simultaneous boost to the dominant intraprostatic lesion: a plan comparison
- Author
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F. Pansini, Cristiana Fodor, Elena Rondi, Giorgia Timon, Dario Zerini, Giuseppe Renne, Federica Cattani, Pola Romanelli, A. Bazani, Ottavio De Cobelli, Raffaella Cambria, Paola Pricolo, Delia Ciardo, Davide Maestri, Roberto Orecchia, Piero Fossati, Stefania Russo, Giuseppe Petralia, Sarah Alessi, Mario Ciocca, Sivia Molinelli, Giulia Marvaso, Barbara Alicja Jereczek-Fossa, and Barbara Vischioni
- Subjects
Male ,Organs at Risk ,Simultaneous integrated boost ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Proton Therapy ,medicine ,Humans ,Proton therapy ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Prostatic Neoplasms ,Radiotherapy Dosage ,General Medicine ,medicine.disease ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Radiotherapy, Intensity-Modulated ,Radiology ,medicine.symptom ,business ,Stereotactic body radiotherapy - Abstract
Objective: To compare different stereotactic body techniques—intensity-modulated radiotherapy with photons and protons, applied to radiotherapy of prostatic cancer—with simultaneous integrated boost (SIB) on the dominant intraprostatic lesion (DIL). Methods: Ten patients were selected for this planning study. Dosimetric results were compared between volumetric modulated arc therapy, intensity-modulated radiation therapy (IMRT), and intensity-modulated proton therapy both with two (IMPT 2F) and five fields (IMPT 5F) planning while applying the prescription schemes of 7.25 Gy/fraction to the prostate gland and 7.5 Gy/fraction to the DIL in 5 fractions. Results: Comparison of the coverages of the planning target volumes showed that small differences exist. The IMPT-2F-5F techniques allowed higher doses in the targets; conformal indexes resulted similar; homogeneity was better in the photon techniques (2%–5%). Regarding the organs at risk, all the techniques were able to maintain the dose well below the prescribed constraints: in the rectum, the IMPT-2F-5F and IMRT were more efficient in lowering the intermediate doses; in the bladder, the median dose was significantly better in the case of IMPT (2F–5F). In the urethra, the best sparing was achieved only by IMPT-5F. Conclusions: Stereotactic radiotherapy with SIB for localized prostate cancer is feasible with all the investigated techniques. Concerning IMPT, the two-beam technique does not seem to have a greater advantage compared to the standard techniques; the 5-beam technique seems more promising also accounting for the range uncertainty.
- Published
- 2021