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IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison

PURPOSE: To compare dosimetric data of the organs at risk (OARs) and clinical target volumes (CTVs) between intensity-modulated proton therapy (IMPT) and volumetric-modulated arc therapy (VMAT) for patients undergoing prostate and elective, pelvic lymph node radiotherapy in the setting of unfavorabl...

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Autores principales: Whitaker, Thomas J., Routman, David M., Schultz, Heather, Harmsen, William S., Corbin, Kimberly S., Wong, William W., Choo, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Particle Therapy Co-operative Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6874187/
https://www.ncbi.nlm.nih.gov/pubmed/31788504
http://dx.doi.org/10.14338/IJPT-18-00048.1
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author Whitaker, Thomas J.
Routman, David M.
Schultz, Heather
Harmsen, William S.
Corbin, Kimberly S.
Wong, William W.
Choo, Richard
author_facet Whitaker, Thomas J.
Routman, David M.
Schultz, Heather
Harmsen, William S.
Corbin, Kimberly S.
Wong, William W.
Choo, Richard
author_sort Whitaker, Thomas J.
collection PubMed
description PURPOSE: To compare dosimetric data of the organs at risk (OARs) and clinical target volumes (CTVs) between intensity-modulated proton therapy (IMPT) and volumetric-modulated arc therapy (VMAT) for patients undergoing prostate and elective, pelvic lymph node radiotherapy in the setting of unfavorable, intermediate and high-risk prostate carcinoma. METHODS AND MATERIALS: A study of moderately hypofractionated proton therapy (6750 centigray [cGy] in 25 fractions) is in progress for unfavorable, intermediate and high-risk prostate cancer where treatment includes an elective pelvic nodal CTV (4500 cGy in 25 fractions). Ten consecutively accrued patients were the subjects for dose-volume histogram comparison between IMPT and VMAT. Two treatment plans (IMPT and VMAT) were prepared for each patient with predefined planning objectives for target volumes and OARs. The IMPT plans were prepared with 2 lateral beams and VMAT plans with 2 arcs. RESULTS: The CTV coverage was adequate for both plans with 99% of CTVs receiving ≥ 100% of the prescription doses. Mean doses to the bladder, rectum, large bowel, and small bowel were lower with IMPT versus VMAT. Mean femoral head dose was greater with IMPT. The percentage of volumes of rectum receiving ≤ 47.5 Gy, large bowel receiving ≤ 27.5 Gy, small bowel receiving ≤ 30 Gy, and bladder receiving ≤ 37.5 Gy was less with IMPT versus VMAT, largely because of reduction in the low-dose “bath” associated with VMAT. CONCLUSIONS: In the setting of prostate and elective, pelvic nodal radiotherapy for prostate cancer, IMPT can significantly reduce the dose to OARs, in comparison to VMAT, and provide adequate target coverage.
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spelling pubmed-68741872019-12-01 IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison Whitaker, Thomas J. Routman, David M. Schultz, Heather Harmsen, William S. Corbin, Kimberly S. Wong, William W. Choo, Richard Int J Part Ther Original Articles PURPOSE: To compare dosimetric data of the organs at risk (OARs) and clinical target volumes (CTVs) between intensity-modulated proton therapy (IMPT) and volumetric-modulated arc therapy (VMAT) for patients undergoing prostate and elective, pelvic lymph node radiotherapy in the setting of unfavorable, intermediate and high-risk prostate carcinoma. METHODS AND MATERIALS: A study of moderately hypofractionated proton therapy (6750 centigray [cGy] in 25 fractions) is in progress for unfavorable, intermediate and high-risk prostate cancer where treatment includes an elective pelvic nodal CTV (4500 cGy in 25 fractions). Ten consecutively accrued patients were the subjects for dose-volume histogram comparison between IMPT and VMAT. Two treatment plans (IMPT and VMAT) were prepared for each patient with predefined planning objectives for target volumes and OARs. The IMPT plans were prepared with 2 lateral beams and VMAT plans with 2 arcs. RESULTS: The CTV coverage was adequate for both plans with 99% of CTVs receiving ≥ 100% of the prescription doses. Mean doses to the bladder, rectum, large bowel, and small bowel were lower with IMPT versus VMAT. Mean femoral head dose was greater with IMPT. The percentage of volumes of rectum receiving ≤ 47.5 Gy, large bowel receiving ≤ 27.5 Gy, small bowel receiving ≤ 30 Gy, and bladder receiving ≤ 37.5 Gy was less with IMPT versus VMAT, largely because of reduction in the low-dose “bath” associated with VMAT. CONCLUSIONS: In the setting of prostate and elective, pelvic nodal radiotherapy for prostate cancer, IMPT can significantly reduce the dose to OARs, in comparison to VMAT, and provide adequate target coverage. The Particle Therapy Co-operative Group 2019-03-21 2019 /pmc/articles/PMC6874187/ /pubmed/31788504 http://dx.doi.org/10.14338/IJPT-18-00048.1 Text en © Copyright 2019 International Journal of Particle Therapy http://creativecommons.org/licenses/by/3.0/ Distributed under Creative Commons CC-BY
spellingShingle Original Articles
Whitaker, Thomas J.
Routman, David M.
Schultz, Heather
Harmsen, William S.
Corbin, Kimberly S.
Wong, William W.
Choo, Richard
IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison
title IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison
title_full IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison
title_fullStr IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison
title_full_unstemmed IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison
title_short IMPT versus VMAT for Pelvic Nodal Irradiation in Prostate Cancer: A Dosimetric Comparison
title_sort impt versus vmat for pelvic nodal irradiation in prostate cancer: a dosimetric comparison
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6874187/
https://www.ncbi.nlm.nih.gov/pubmed/31788504
http://dx.doi.org/10.14338/IJPT-18-00048.1
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