Development of a simultaneous boost IMRT class solution for a hypofractionated prostate cancer protocol.

2.50
Hdl Handle:
http://hdl.handle.net/10541/78123
Title:
Development of a simultaneous boost IMRT class solution for a hypofractionated prostate cancer protocol.
Authors:
Mott, Judith; Livsey, Jacqueline E; Logue, John P
Abstract:
The purpose of this work was to develop a robust technique for planning intensity-modulated radiation therapy (IMRT) for prostate cancer patients who are to be entered into a proposed hypofractionated dose escalation study. In this study the dose escalation will be restricted to the prostate alone, which may be regarded as a concurrent boost volume within the overall planning target volume (PTV). The dose to the prostate itself is to be delivered in 3 Gy fractions, and for this phase of the study the total prostate dose will be 57 Gy in 19 fractions, with 50 Gy prescribed to the rest of the PTV. If acute toxicity results are acceptable, the next phase will escalate doses to 60 Gy in 20 x 3 Gy fractions. There will be 30 patients in each arm. This work describes the class solution which was developed to create IMRT plans for this study, and which enabled the same set of inverse planning parameters to be used during optimization for every patient with minimal planner intervention. The resulting dose distributions were compared with those that would be achieved from a 3D conformal radiotherapy (3DCRT) technique that used a multileaf collimator (MLC) but no intensity modulation to treat the PTV, followed by a sequential boost to raise the prostate to 57 Gy. The two methods were tested on anatomical data sets for a series of 10 patients who would have been eligible for this study, and the techniques were compared in terms of doses to the target volumes and the organs at risk. The IMRT method resulted in much greater sparing of the rectum and bladder than the 3DCRT technique, whilst still delivering acceptable doses to the target volumes. In particular, the volume of rectum receiving the minimum PTV dose of 47.5 Gy was reduced from a mean value of 36.9% (range 23.4% to 61.0%) to 18.6% (10.3% to 29.0%). In conclusion, it was found possible to use a class solution approach to produce IMRT dose escalated plans. This IMRT technique has since been implemented clinically for patients enrolled in the hypofractionated dose escalation study.
Affiliation:
North Western Medical Physics and Clinical Oncology, Christie Hospital NHS Trust, Manchester M20 4BX, UK.
Citation:
Development of a simultaneous boost IMRT class solution for a hypofractionated prostate cancer protocol. 2004, 77 (917):377-86 Br J Radiol
Journal:
The British Journal of Radiology
Issue Date:
May-2004
URI:
http://hdl.handle.net/10541/78123
PubMed ID:
15121701
Type:
Article
Language:
en
ISSN:
0007-1285
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMott, Judith-
dc.contributor.authorLivsey, Jacqueline E-
dc.contributor.authorLogue, John P-
dc.date.accessioned2009-08-21T09:22:27Z-
dc.date.available2009-08-21T09:22:27Z-
dc.date.issued2004-05-
dc.identifier.citationDevelopment of a simultaneous boost IMRT class solution for a hypofractionated prostate cancer protocol. 2004, 77 (917):377-86 Br J Radiolen
dc.identifier.issn0007-1285-
dc.identifier.pmid15121701-
dc.identifier.urihttp://hdl.handle.net/10541/78123-
dc.description.abstractThe purpose of this work was to develop a robust technique for planning intensity-modulated radiation therapy (IMRT) for prostate cancer patients who are to be entered into a proposed hypofractionated dose escalation study. In this study the dose escalation will be restricted to the prostate alone, which may be regarded as a concurrent boost volume within the overall planning target volume (PTV). The dose to the prostate itself is to be delivered in 3 Gy fractions, and for this phase of the study the total prostate dose will be 57 Gy in 19 fractions, with 50 Gy prescribed to the rest of the PTV. If acute toxicity results are acceptable, the next phase will escalate doses to 60 Gy in 20 x 3 Gy fractions. There will be 30 patients in each arm. This work describes the class solution which was developed to create IMRT plans for this study, and which enabled the same set of inverse planning parameters to be used during optimization for every patient with minimal planner intervention. The resulting dose distributions were compared with those that would be achieved from a 3D conformal radiotherapy (3DCRT) technique that used a multileaf collimator (MLC) but no intensity modulation to treat the PTV, followed by a sequential boost to raise the prostate to 57 Gy. The two methods were tested on anatomical data sets for a series of 10 patients who would have been eligible for this study, and the techniques were compared in terms of doses to the target volumes and the organs at risk. The IMRT method resulted in much greater sparing of the rectum and bladder than the 3DCRT technique, whilst still delivering acceptable doses to the target volumes. In particular, the volume of rectum receiving the minimum PTV dose of 47.5 Gy was reduced from a mean value of 36.9% (range 23.4% to 61.0%) to 18.6% (10.3% to 29.0%). In conclusion, it was found possible to use a class solution approach to produce IMRT dose escalated plans. This IMRT technique has since been implemented clinically for patients enrolled in the hypofractionated dose escalation study.en
dc.language.isoenen
dc.subjectProstatic Canceren
dc.subject.meshClinical Protocols-
dc.subject.meshDose Fractionation-
dc.subject.meshFemur Head-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshProstatic Neoplasms-
dc.subject.meshRadiation Dosage-
dc.subject.meshRadiotherapy Dosage-
dc.subject.meshRadiotherapy Planning, Computer-Assisted-
dc.subject.meshRadiotherapy, Conformal-
dc.subject.meshRectum-
dc.subject.meshUrinary Bladder-
dc.titleDevelopment of a simultaneous boost IMRT class solution for a hypofractionated prostate cancer protocol.en
dc.typeArticleen
dc.contributor.departmentNorth Western Medical Physics and Clinical Oncology, Christie Hospital NHS Trust, Manchester M20 4BX, UK.en
dc.identifier.journalThe British Journal of Radiologyen

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