1. Neurovascular Bundle Infiltration Can Explain Local Relapses Using Conformal Radiotherapy of Prostate Cancer
- Author
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Andreas K. Johansson, Ulf Isacsson, and B. Lennernäs
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,030232 urology & nephrology ,Urology ,Conformal radiotherapy ,Adenocarcinoma ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,medicine ,Arc therapy ,Humans ,Neovascularization, Pathologic ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Prostatic Neoplasms ,Radiotherapy Dosage ,General Medicine ,Neurovascular bundle ,medicine.disease ,Prognosis ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Radiology ,Radiotherapy, Intensity-Modulated ,Neoplasm Grading ,Neoplasm Recurrence, Local ,Radiotherapy, Conformal ,business ,Infiltration (medical) - Abstract
To quantify the impact of decreased margins for two treatment techniques, three-dimensional conformal radiotherapy (3D-CRT) and volumetric-modulated arc therapy (VMAT), on local control in curative treatment of prostate cancer.The planning target volume (PTV) margins were decreased in steps of 1 mm from 10 to 1 mm. Treatment plans using 3D-CRT and VMAT technique were produced for all margin sizes and the dose to the neuro vascular bundles (NVB), that was not included in the PTV, was investigated.Due to the more conformal dose delivery using VMAT, the dose to the NVB decreased more rapidly by VMAT compared to the 3D-CRT plans. The dose difference was significant for margins from 1-7 mm.One should be very cautious before clinical routines are changed, bearing in mind whether the change means more conformal treatment technique, smaller margins or target segmentation in different imaging modalities.
- Published
- 2017