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Evaluation of the conformal radiotherapy techniques in prostate cancer

Year 2009, Volume: 24 Issue: 4, 166 - 171, 01.05.2009

Abstract

OBJECTIVES We aimed to determine the optimal radiotherapy technique enabling the most homogenous dose distribution for Clinic Target Volume (CTV) and Planned Target Volume (PTV) and providing conformal avoidance of Organs at Risk (OAR). METHODS CTV, PTV, and OAR were outlined by utilization of Sim-Pro (CMS-USA) using 5 mm slice spaced computed tomography scans. For each patient, individual 4, 5, 6, and 7 field plans, with 18 MV photons, were assessed with XiO (CMS-USA) 3D planning workstation. RESULTS In comparing the different techniques, the greatest rectal sparing was achieved with the 5 field plan (Rectal: 5F V25%=59.90±6.8 Gy, 4F V25%=62.30±10.3 Gy, 6F V25%=69.36±5.7 Gy, 7F V25%=61.32±7.3 Gy). CONCLUSION While all the techniques achieved the goal of optimal homogeneity of CTV-PTV, 4F provided the lowest femoral doses. The greatest rectal sparing was achieved with 5 field conformal technique.

References

  • 1. Roach III M, Wallner K. Cancer of the prostate. In: Leibel SA, Phillips TL, editors. Textbook of Radiation Oncology. 2nd ed. Philadelphia: Saunders; 2004. p. 959-1030.
  • 2. American Cancer Society. Cancer facts and figures. New York: ACS; 1997.
  • 3. Quinn M, Babb P, Brock A, Kİrby L. Office for National statistics. Prostate. Cancer trends 1950-1999. London The Stationary Office: 2001. p. 126-31.
  • 4. Kupelian PA, Potters L, Khuntia D, Ciezki JP, Reddy CA, Reuther AM, et al. Radical prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy > or =72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1-T2 prostate cancer. Int J Radiat Oncol Biol Phys 2004;58(1):25-33.
  • 5. Benk VA, Adams JA, Shipley WU, Urie MM, McManus PL, Efird JT, et al. Late rectal bleeding following combined X-ray and proton high dose irradiation for patients with stages T3-T4 prostate carcinoma. Int J Radiat Oncol Biol Phys 1993;26(3):551-7.
  • 6. Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991;21(1):109-22.
  • 7. Chuba PJ, Sharma R, Yudelev M, Duclos M, Shamsa F, Giacalone S, et al. Hip stiffness following mixed conformal neutron and photon radiotherapy: a dosevolume relationship. Int J Radiat Oncol Biol Phys 1996;35(4):693-9.
  • 8. Kuban DA, Thames HD, Levy LB, Horwitz EM, Kupelian PA, Martinez AA, et al. Long-term multi-institutional analysis of stage T1-T2 prostate cancer treated with radiotherapy in the PSA era. Int J Radiat Oncol Biol Phys 2003;57(4):915-28.
  • 9. Zietman AL, DeSilvio ML, Slater JD, Rossi CJ Jr, Miller DW, Adams JA, et al. Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA 2005;294(10):1233-9.
  • 10. Zelefsky MJ, Fuks Z, Happersett L, Lee HJ, Ling CC, Burman CM, et al. Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer. Radiother Oncol 2000;55(3):241-9.
  • 11. Bedford JL, Henrys AJ, Dearnaley DP, Khoo VS. Treatment planning evaluation of non-coplanar techniques for conformal radiotherapy of the prostate. Radiother Oncol 2005;75(3):287-92.
  • 12. Zhu S, Mizowaki T, Nagata Y, Takayama K, Norihisa Y, Yano S, et al. Comparison of three radiotherapy treatment planning protocols of definitive externalbeam radiation for localized prostate cancer. Int J Clin Oncol 2005;10(6):398-404.
  • 13. Khoo VS, Bedford JL, Webb S, Dearnaley DP. Class solutions for conformal external beam prostate radiotherapy. Int J Radiat Oncol Biol Phys 2003;55(4):1109- 20.
  • 14. Lee CT, Dong L, Ahamad AW, Choi H, Cheung R, Lee AK, et al. Comparison of treatment volumes and techniques in prostate cancer radiation therapy. Am J Clin Oncol 2005;28(6):618-25.
  • 15. Gershkevitsh E, Rosenberg I, Dearnaley DP, Trott KR. Bone marrow doses and leukaemia risk in radiotherapy of prostate cancer. Radiother Oncol 1999;53(3):189- 97.
  • 16. Pollack A, Zagars GK. External beam radiotherapy dose response of prostate cancer. Int J Radiat Oncol Biol Phys 1997;39(5):1011-8.

Prostat kanserinin radyoterapisinde konformal radyoterapi tekniklerinin değerlendirilmesi

Year 2009, Volume: 24 Issue: 4, 166 - 171, 01.05.2009

Abstract

AMAÇ Prostat kanseri tanılı hastaların konformal radyoterapisinde farklı tedavi teknikleri kullanılarak PTV ve CTV için en homojen doz dağılımını veren, bununla beraber doz sınırlayıcı organ olan mesane, rektum ve femur başı için en uygun teknik araştırıldı. GEREÇ VE YÖNTEM Hastalardan, bilgisayarlı tomografi cihazı aracıyla 5 mm'lik kesitler alındı. Volüm tanımlama işlemi yapıldıktan sonra XiO (CMS-USA) 3D tedavi planlama bilgisayarında her hasta için 4, 5, 6 ve 7 alan 18MV X ışınları ile konformal tedavi planları yapıldı. BULGULAR Rektum için en iyi korumanın 5 alanlı konformal radyoterapi tekniğinde yapılabildiği saptandı. (Rektum için: 5 alan, %25'i 59.90±6.8 Gy; 4 alan, %25'i 62.30±10.3 Gy; 6 alan, %25'i 69.36±5.7 Gy; 7 alan %25'i 61.32±7.3 Gy). SONUÇ Bütün tekniklerde PTV, CTV için uygun doz homojenitesi sağlanırken, 4 alanlı konformal radyoterapi tekniğinde femur dozlarının diğer tekniklere göre daha düşük olduğu görüldü. Rektum için en iyi korumanın 5 alanlı konformal radyoterapi tekniğinde yapılabildiğini saptadık.

References

  • 1. Roach III M, Wallner K. Cancer of the prostate. In: Leibel SA, Phillips TL, editors. Textbook of Radiation Oncology. 2nd ed. Philadelphia: Saunders; 2004. p. 959-1030.
  • 2. American Cancer Society. Cancer facts and figures. New York: ACS; 1997.
  • 3. Quinn M, Babb P, Brock A, Kİrby L. Office for National statistics. Prostate. Cancer trends 1950-1999. London The Stationary Office: 2001. p. 126-31.
  • 4. Kupelian PA, Potters L, Khuntia D, Ciezki JP, Reddy CA, Reuther AM, et al. Radical prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy > or =72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1-T2 prostate cancer. Int J Radiat Oncol Biol Phys 2004;58(1):25-33.
  • 5. Benk VA, Adams JA, Shipley WU, Urie MM, McManus PL, Efird JT, et al. Late rectal bleeding following combined X-ray and proton high dose irradiation for patients with stages T3-T4 prostate carcinoma. Int J Radiat Oncol Biol Phys 1993;26(3):551-7.
  • 6. Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991;21(1):109-22.
  • 7. Chuba PJ, Sharma R, Yudelev M, Duclos M, Shamsa F, Giacalone S, et al. Hip stiffness following mixed conformal neutron and photon radiotherapy: a dosevolume relationship. Int J Radiat Oncol Biol Phys 1996;35(4):693-9.
  • 8. Kuban DA, Thames HD, Levy LB, Horwitz EM, Kupelian PA, Martinez AA, et al. Long-term multi-institutional analysis of stage T1-T2 prostate cancer treated with radiotherapy in the PSA era. Int J Radiat Oncol Biol Phys 2003;57(4):915-28.
  • 9. Zietman AL, DeSilvio ML, Slater JD, Rossi CJ Jr, Miller DW, Adams JA, et al. Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA 2005;294(10):1233-9.
  • 10. Zelefsky MJ, Fuks Z, Happersett L, Lee HJ, Ling CC, Burman CM, et al. Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer. Radiother Oncol 2000;55(3):241-9.
  • 11. Bedford JL, Henrys AJ, Dearnaley DP, Khoo VS. Treatment planning evaluation of non-coplanar techniques for conformal radiotherapy of the prostate. Radiother Oncol 2005;75(3):287-92.
  • 12. Zhu S, Mizowaki T, Nagata Y, Takayama K, Norihisa Y, Yano S, et al. Comparison of three radiotherapy treatment planning protocols of definitive externalbeam radiation for localized prostate cancer. Int J Clin Oncol 2005;10(6):398-404.
  • 13. Khoo VS, Bedford JL, Webb S, Dearnaley DP. Class solutions for conformal external beam prostate radiotherapy. Int J Radiat Oncol Biol Phys 2003;55(4):1109- 20.
  • 14. Lee CT, Dong L, Ahamad AW, Choi H, Cheung R, Lee AK, et al. Comparison of treatment volumes and techniques in prostate cancer radiation therapy. Am J Clin Oncol 2005;28(6):618-25.
  • 15. Gershkevitsh E, Rosenberg I, Dearnaley DP, Trott KR. Bone marrow doses and leukaemia risk in radiotherapy of prostate cancer. Radiother Oncol 1999;53(3):189- 97.
  • 16. Pollack A, Zagars GK. External beam radiotherapy dose response of prostate cancer. Int J Radiat Oncol Biol Phys 1997;39(5):1011-8.
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Aydın Çakır This is me

Fulya Ağaoğlu This is me

Bilgehan Şahin This is me

Murat Okutan This is me

Yavuz Dizdar This is me

Emin Darendelioğlu This is me

Publication Date May 1, 2009
Published in Issue Year 2009 Volume: 24 Issue: 4

Cite

APA Çakır, A., Ağaoğlu, F., Şahin, B., Okutan, M., et al. (2009). Prostat kanserinin radyoterapisinde konformal radyoterapi tekniklerinin değerlendirilmesi. Türk Onkoloji Dergisi, 24(4), 166-171.
AMA Çakır A, Ağaoğlu F, Şahin B, Okutan M, Dizdar Y, Darendelioğlu E. Prostat kanserinin radyoterapisinde konformal radyoterapi tekniklerinin değerlendirilmesi. Türk Onkoloji Dergisi. May 2009;24(4):166-171.
Chicago Çakır, Aydın, Fulya Ağaoğlu, Bilgehan Şahin, Murat Okutan, Yavuz Dizdar, and Emin Darendelioğlu. “Prostat Kanserinin Radyoterapisinde Konformal Radyoterapi Tekniklerinin değerlendirilmesi”. Türk Onkoloji Dergisi 24, no. 4 (May 2009): 166-71.
EndNote Çakır A, Ağaoğlu F, Şahin B, Okutan M, Dizdar Y, Darendelioğlu E (May 1, 2009) Prostat kanserinin radyoterapisinde konformal radyoterapi tekniklerinin değerlendirilmesi. Türk Onkoloji Dergisi 24 4 166–171.
IEEE A. Çakır, F. Ağaoğlu, B. Şahin, M. Okutan, Y. Dizdar, and E. Darendelioğlu, “Prostat kanserinin radyoterapisinde konformal radyoterapi tekniklerinin değerlendirilmesi”, Türk Onkoloji Dergisi, vol. 24, no. 4, pp. 166–171, 2009.
ISNAD Çakır, Aydın et al. “Prostat Kanserinin Radyoterapisinde Konformal Radyoterapi Tekniklerinin değerlendirilmesi”. Türk Onkoloji Dergisi 24/4 (May 2009), 166-171.
JAMA Çakır A, Ağaoğlu F, Şahin B, Okutan M, Dizdar Y, Darendelioğlu E. Prostat kanserinin radyoterapisinde konformal radyoterapi tekniklerinin değerlendirilmesi. Türk Onkoloji Dergisi. 2009;24:166–171.
MLA Çakır, Aydın et al. “Prostat Kanserinin Radyoterapisinde Konformal Radyoterapi Tekniklerinin değerlendirilmesi”. Türk Onkoloji Dergisi, vol. 24, no. 4, 2009, pp. 166-71.
Vancouver Çakır A, Ağaoğlu F, Şahin B, Okutan M, Dizdar Y, Darendelioğlu E. Prostat kanserinin radyoterapisinde konformal radyoterapi tekniklerinin değerlendirilmesi. Türk Onkoloji Dergisi. 2009;24(4):166-71.