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Lymphocyte-sparing pelvic radiotherapy for prostate cancer: An in-silico study
BACKGROUND AND PURPOSE: Evidence regarding radiation-induced lymphopenia and its negative impact on oncological outcome is incrementing. Therefore, the aim of this study is to evaluate the feasibility of lymphocyte-rich organs at risk (LOAR) sparing in pelvic irradiation for localized prostate cance...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356260/ https://www.ncbi.nlm.nih.gov/pubmed/35941862 http://dx.doi.org/10.1016/j.phro.2022.07.006 |
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author | Baré, Mathilde Poeta, Sara Fernandes, Patricia Jourani, Younes Otte, François-Xavier Van Brussel, Sara Van Gestel, Dirk Van den Begin, Robbe |
author_facet | Baré, Mathilde Poeta, Sara Fernandes, Patricia Jourani, Younes Otte, François-Xavier Van Brussel, Sara Van Gestel, Dirk Van den Begin, Robbe |
author_sort | Baré, Mathilde |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Evidence regarding radiation-induced lymphopenia and its negative impact on oncological outcome is incrementing. Therefore, the aim of this study is to evaluate the feasibility of lymphocyte-rich organs at risk (LOAR) sparing in pelvic irradiation for localized prostate cancer and to estimate its impact on the effective dose to circulating immune cells (EDIC). MATERIALS AND METHODS: Twenty patients with pelvic nodal and prostate or prostate bed irradiation were included. The following bone marrow (BM) structures were delineated as LOARs using semi-automatic segmentation: lumbosacral spine (Ls-BM), ilium (Il-BM), lower pelvis (Lp-BM), and the combined whole-pelvis (Wp-BM). Twenty new lymphocyte sparing treatment plans (LS plans) were calculated, optimizing doses to LOARs while maintaining strict coverage of the targets and respecting standard OARs dose constraints. Finally, we elaborated an EDIC calculation model for pelvic irradiation. RESULTS: LS plans showed a statistically significant dose decrease for LOAR compared to standard of care plans without compromising target coverage nor classic OAR dose constraints: in prostate plans, the V40Gy for Ls-BM, Il-BM, and Lp-BM was decreased by 23 %, 36 %, 52 % respectively. For prostate bed plans, the V40Gy for Ls-BM, Il-BM, and Lp-BM was decreased by 25 %, 59 %, 56 %, respectively. For Wp-BM, the V10Gy, V20Gy, and Dmean have been decreased by 3 %, 14 %, 15 %, and by 5 %, 15 %, 17 %, respectively for prostate and prostate bed plans. A statistically significant decrease in EDIC was seen for LS plans in both groups. CONCLUSIONS: We successfully demonstrated the feasability of lympocyte-sparing treatment planning in pelvic irradiation, also proposing a model for EDIC calculation. |
format | Online Article Text |
id | pubmed-9356260 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-93562602022-08-07 Lymphocyte-sparing pelvic radiotherapy for prostate cancer: An in-silico study Baré, Mathilde Poeta, Sara Fernandes, Patricia Jourani, Younes Otte, François-Xavier Van Brussel, Sara Van Gestel, Dirk Van den Begin, Robbe Phys Imaging Radiat Oncol Original Research Article BACKGROUND AND PURPOSE: Evidence regarding radiation-induced lymphopenia and its negative impact on oncological outcome is incrementing. Therefore, the aim of this study is to evaluate the feasibility of lymphocyte-rich organs at risk (LOAR) sparing in pelvic irradiation for localized prostate cancer and to estimate its impact on the effective dose to circulating immune cells (EDIC). MATERIALS AND METHODS: Twenty patients with pelvic nodal and prostate or prostate bed irradiation were included. The following bone marrow (BM) structures were delineated as LOARs using semi-automatic segmentation: lumbosacral spine (Ls-BM), ilium (Il-BM), lower pelvis (Lp-BM), and the combined whole-pelvis (Wp-BM). Twenty new lymphocyte sparing treatment plans (LS plans) were calculated, optimizing doses to LOARs while maintaining strict coverage of the targets and respecting standard OARs dose constraints. Finally, we elaborated an EDIC calculation model for pelvic irradiation. RESULTS: LS plans showed a statistically significant dose decrease for LOAR compared to standard of care plans without compromising target coverage nor classic OAR dose constraints: in prostate plans, the V40Gy for Ls-BM, Il-BM, and Lp-BM was decreased by 23 %, 36 %, 52 % respectively. For prostate bed plans, the V40Gy for Ls-BM, Il-BM, and Lp-BM was decreased by 25 %, 59 %, 56 %, respectively. For Wp-BM, the V10Gy, V20Gy, and Dmean have been decreased by 3 %, 14 %, 15 %, and by 5 %, 15 %, 17 %, respectively for prostate and prostate bed plans. A statistically significant decrease in EDIC was seen for LS plans in both groups. CONCLUSIONS: We successfully demonstrated the feasability of lympocyte-sparing treatment planning in pelvic irradiation, also proposing a model for EDIC calculation. Elsevier 2022-07-30 /pmc/articles/PMC9356260/ /pubmed/35941862 http://dx.doi.org/10.1016/j.phro.2022.07.006 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Article Baré, Mathilde Poeta, Sara Fernandes, Patricia Jourani, Younes Otte, François-Xavier Van Brussel, Sara Van Gestel, Dirk Van den Begin, Robbe Lymphocyte-sparing pelvic radiotherapy for prostate cancer: An in-silico study |
title | Lymphocyte-sparing pelvic radiotherapy for prostate cancer: An in-silico study |
title_full | Lymphocyte-sparing pelvic radiotherapy for prostate cancer: An in-silico study |
title_fullStr | Lymphocyte-sparing pelvic radiotherapy for prostate cancer: An in-silico study |
title_full_unstemmed | Lymphocyte-sparing pelvic radiotherapy for prostate cancer: An in-silico study |
title_short | Lymphocyte-sparing pelvic radiotherapy for prostate cancer: An in-silico study |
title_sort | lymphocyte-sparing pelvic radiotherapy for prostate cancer: an in-silico study |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356260/ https://www.ncbi.nlm.nih.gov/pubmed/35941862 http://dx.doi.org/10.1016/j.phro.2022.07.006 |
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