Dosimetric Evaluation of Intensity Modulated Radiotherapy and 4-Field 3-D Conformal Radiotherapy in Prostate Cancer Treatment

Yıl 2013, Cilt: 2013 Sayı: 1, 54 - 57, 01.01.2013

Bora Uysal Murat Beyzadeoğlu Ömer Sager Ferrat Dinçoğlan Selçuk Demiral Hakan Gamsız Serdar Sürenkök Kaan Oysul

https://doi.org/10.5152/balkanmedj.2012.075

Öz

Objective: The purpose of this dosimetric study is the targeted dose homogeneity and critical organ dose comparison of 7-field Intensity Modulated Radiotherapy (IMRT) and 3-D 4-field conformal radiotherapy. Study Design: Cross sectional study. Material and Methods: Twenty patients with low and moderate risk prostate cancer treated at Gülhane Military Medical School Radiation Oncology Department between January 2009 and December 2009 are included in this study. Two seperate dosimetric plans both for 7-field IMRT and 3D-CRT have been generated for each patient to comparatively evaluate the dosimetric status of both techniques and all the patients received 7-field IMRT. Results: Dose-comparative evaluation of two techniques revealed the superiority of IMRT technique with statistically significantly lower femoral head doses along with reduced critical organ dose-volume parameters of bladder V60 (the volume receiving 60 Gy) and rectal V40 (the volume receiving 40 Gy) and V60. Conclusion: It can be concluded that IMRT is an effective definitive management tool for prostate cancer with improved critical organ sparing and excellent dose homogenization in target organs of prostate and seminal vesicles. Turkish Anahtar Kelimeler: Prostat kanseri, YART, 3-B Konformal RT Amaç: Bu dozimetrik çalışmanın amacı 7-alan Yoğunluk Ayarlı Radyoterapi (YART) ve 3-Boyutlu 4-Alan Konformal Radyoterapi (3BKRT)'nin hedef doz homojenitesi ve kritik organ dozlarının karşılaştırılmasıdır. Gereç ve Yöntemler: Gülhane Askeri Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalı'nda Ocak 2009 ve Aralık 2009 yılları arasında düşük ve orta riskli prostat kanseri tanısıyla tedavi edilen 20 hasta bu çalışmaya dahil edildi. 7-alan Yoğunluk Ayarlı Radyoterapi (YART) ve 3BKRT'nin her ikisi için ayrı iki dozimetrik plan 7-alan YART uygulanan tüm hastaları ve her iki tekniğin dozimetrik durumunu değerlendirmek için düzenlendi. Bulgular: İki tekniğin doz karşılaştırmalı değerlendirilmesi YART tekniğinin istatistiksel olarak belirgin oranda düşük femur başı dozları ile azalmış mesane V60( 60 Gy alan volüm) ve rektal V40 ( 40 Gy alan volüm) kritik organ doz volüm parametreleriyle üstünlüğünü gösterdi. Sonuç: Sonuç olarak YART gelişmiş kritik organ koruma ve hedef organlar olan prostat ve seminal veziküllerin mükemmel doz homojenizasyonuyla prostat kanserinde etkili ve küratif bir tedavi aracıdır.

Anahtar Kelimeler

Intensity-modulated radiotherapy, prostate cancer, three-dimensional conformal radiotherapy

Dosimetric Evaluation of Intensity Modulated Radiotherapy and 4-Field 3-D Conformal Radiotherapy in Prostate Cancer Treatment

Öz

Kaynakça

• Beyzadeoğlu M, Ozyigit G, Ebruli C, editors. Basic Radiation Oncology. Berlin:Springer;2008. p.363-385.
• Hanks GE, Leibel SA, Kral JM. Patterns of care studies:doseresponse observations for local control of adenocarcinoma of the prostate. Int J Radiat Oncol Biol Phys 1985;11:153-7. [CrossRef]
• Hanks GE, Martz KL, Diamond JJ. The effect of dose on local control of prostate cancer. Int J Radiat Oncol Biol Phys 1988;15:1299-305. [CrossRef]
• Sandler HM, Perez-Tamayo C, Ten Haken RK. Dose escalation for stage C (T3) prostate cancer:minimal toxicity observed using conformal therapy. Radiother Oncol 1992;23:53-4. [CrossRef]
• Hanks GE, Hanlon AL, Schultheiss TE. Dose escalation with 3D conformal treatment:five year outcomes, treatment optimization, and future directions. Int J Radiat Oncol Biol Phys 1998;41:501-10. [CrossRef]
• Zelefsky MJ, Leibel SA, Gaudin PB. Dose escalation with threedimensional conformal radiation therapy affects the outcome in prostate cancer. Int J Radiat Oncol Biol Phys 1998;41:491-500. [CrossRef]
• Michalski JM, Purdy JA, Winter K. Preliminary report of toxicity following 3D radiation therapy for prostate cancer on 3DOG/ RTOG 94-06. Int J Radiat Oncol Biol Phys 2000;46:391-402. [CrossRef]
• Ryu JK, Winter K, Michalski JM. Interim report of toxicity from 3D conformal radiation therapy (3D-CRT) for prostate cancer on 3DOG/RTOG 9406, level III (79.2 Gy). Int J Radiat Oncol Biol Phys 2002;54:1036-46. [CrossRef]
• Luxton G, Hancock SL, Boyer AL. Dosimetry and radiobiologic model comparison of IMRT and 3D conformal radiotherapy in treatment of carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2004;59:267-84. [CrossRef]
• Latorzeff I, Mazurier J, Boutry C, Duodet P, Richaud P, Crovesier R. Benefit of intensity modulated and image-guided radiotherapy in prostate cancer. Cancer Radiother 2010;14:479-87. [CrossRef]
• Zelefsky M, Fuksa Z, Happersett L, Leea H, Lingb C, Burman C, et al. Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer. Radiother Oncol 2000;55:241 [CrossRef]
• 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;28:618-25. [CrossRef]
• Zhu S, Mizowaki T, Nagata Y, Takayama K, Norihisa Y, Yo S, et al. Comparison of three radiotherapy treatment planning protocols of definitive external-beam radiation for localized prostate cancer. Int J Clin Oncol 2005;10:398-404. [CrossRef]
• Wolff D, Stieler F, Welzel G, Lorenz F, Abo-Madyan Y, Mai S, et al. Volumetric modulated arc therapy (VMAT) vs. serial tomotherapy, step-and-shoot IMRT and 3D-conformal RT for treatment of prostate cancer. Radiother Oncol 2009;93:226-33. [CrossRef]
• Vaarkamp J, Adams E, Warrington A, Dearnaley D. A comparison of forward and inverse planned conformal, multi segment and intensity modulated radiotherapy for the treatment of prostate and pelvic nodes Radiother Oncol 2004;73:65-72. [CrossRef]
• Fenoglietto P, Laliberte B, Allawa A, Ailleresa N, Idria K, Haya M, et al. Persistently better treatment planning results of intensitymodulated (IMRT) over conformal radiotherapy (3D-CRT) in prostate cancer patients with significant variation of clinical target volume and/or organs-at-risk. Radiother Oncol 2008;88:77-87. [CrossRef]
• Wachter S, Gerstner N, Dorner D. The influence of rectal balloon tube as internal immobilization device on variations of volumes and dose-volume histograms during treatment course of conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2002;52:91-100. [CrossRef]
• Buckey C, Swanson G, Stathakis S, Papanikolau N. Dosimetric comparison between 3D conformal and intensity-modulated radiation therapy for prostate cancer. J Radiother Pract 2010;9:77-85. [CrossRef]
• Hall E, Wuu C. Radiation-induced second cancers:The impact of 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys 2003;56:83-8. [CrossRef]