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Focal salvage treatment for radiorecurrent prostate cancer: A magnetic resonance-guided stereotactic body radiotherapy versus high-dose-rate brachytherapy planning study
- Source :
- Physics and Imaging in Radiation Oncology, Vol 15, Iss, Pp 60-65 (2020), Physics and Imaging in Radiation Oncology
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Highlights • SBRT may provide a non-invasive treatment option for recurrent prostate cancer. • MR-Linac single fraction 19 Gy treatment of recurrent prostate cancer is feasible. • MR-Linac dose distributions for the target were comparable to HDR-brachytherapy. • Real-time intrafraction adaptation techniques are needed for clinical introduction.<br />Background and Purpose Magnetic resonance imaging (MRI)-guided focal salvage high-dose-rate brachytherapy (FS-HDR-BT) is one of the treatment options for radiorecurrent localized prostate cancer. However, due to the invasive nature of the treatment, not all patients are eligible. Magnetic resonance linear accelerator (MR-Linac) systems open up new treatment possibilities and could potentially replace FS-HDR-BT treatment. We conducted a planning study to investigate the feasibility of delivering a single 19 Gy dose to the recurrent lesion using a 1.5 Tesla MR-Linac system. Materials and Methods Thirty patients who underwent FS-HDR-BT were included. The clinical target volume (CTV) encompassed the visible lesion plus a 5 mm margin. Treatment plans were created for a 1.5 Tesla MR-Linac system using a 1 mm planning target volume (PTV) margin. A dose of 19 Gy was prescribed to ≥ 95% of the PTV. In case this target could not be reached, i.e. when organs-at-risk (OAR) constraints were violated, a dose of ≥ 17 Gy to ≥ 90% of the PTV was accepted. MR-Linac plans were compared to clinical FS-HDR-BT plans. Results Target dose coverage was achieved in 14/30 (47%) FS-HDR-BT plans and 17/30 (57%) MR-Linac plans, with comparable median D95% and D90%. In FS-HDR-BT plans, a larger volume reached ≥ 150% of the prescribed dose. Urethra D10%, rectum D1cm3, and rectum D2cm3 were lower in the FS-HDR-BT plans, while bladder dose was comparable for both modalities. Conclusion Single fraction treatment of recurrent prostate cancer lesions may be feasible using stereotactic body radiotherapy (SBRT) on a MR-Linac system.
- Subjects :
- lcsh:Medical physics. Medical radiology. Nuclear medicine
lcsh:R895-920
medicine.medical_treatment
Brachytherapy
Radiotherapy treatment planning
Rectum
lcsh:RC254-282
030218 nuclear medicine & medical imaging
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Single fraction
Planning study
medicine
Radiology, Nuclear Medicine and imaging
Original Research Article
Focal salvage high-dose-rate brachytherapy
MR-Linac
SBRT
Radiation
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
High-Dose Rate Brachytherapy
Urethra
medicine.anatomical_structure
030220 oncology & carcinogenesis
MRI-guided radiotherapy
business
Nuclear medicine
Stereotactic body radiotherapy
Subjects
Details
- ISSN :
- 24056316
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- Physics and Imaging in Radiation Oncology
- Accession number :
- edsair.doi.dedup.....7e887b98ca2950360c63211ffd0cc5bd