Evaluation of thE dosimEtric and radiobiological impacts on prostatE cancEr patiEnts of daily imagE-guidEd volumEtric modulatEd arc thErapy

Chun-You Chen, Hsiao-Wei Yu, Chiu-Ping Chen, Chi-Yeh Lin, Chih-Cheng Chou, Tzu-Hsin Chen, Yi Ju Chen, Hao Wang, Chun-I Li, Chia Yi Tsai, Chia Hui Chen, Szu-Yuan Wu

Research output: Contribution to journalArticle

Abstract

Purpose: Image-guided radiation therapy (IGRT) was suggested to improve outcomes and reduce toxicity for localized prostate cancer treatment. We generated virtual treatment plans to evaluate the dosimetric impacts with and without IGRT. Materials and Methods: Daily position setup errors from 10 patients treated with volumetric modulated arc therapy (VMAT) were acquired with cone-beam computed tomography (CBCT). A margin of 5 mm was added to the clinical target volume (CTV) to generate a planned target volume (PTV). We shifted the isocenters in the planning system with errors, fraction by fraction, to simulate the situation without IGRT. Dosimetric indices were compared between the initial plans (pretreatment CT plans) and the shifted plans. Radiobiological evaluations of an equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were also performed. Results : The system errors (Σ) and random errors (σ) in the left-right (LR), superiorinferior (SI), and anterior-posterior (AP) directions were Σ LR=1.4 mm, σ LR= 1.95 mm, Σ SI =3.22 mm, σ SI = 2.46 mm, Σ AP=3.17 mm and σ AP = 2.79 mm. Coverage of the CTV for 100% and 95% of the prescribed doses were lower in the shifted plans (V100%: 99.99% vs. 92.37%, p < 0.05 and V95%: 100% vs. 99.46%, p < 0.05). There was no difference in the dosimetric indices for the bladder and rectum. The EUD value of the CTV was also lower in the shifted plan (76.8 Gy vs. 75.4 Gy, p < 0.05). The EUD and NTCP for the bladder and rectum did not statistically differ. Conclusions: Using CBCT-acquired VMAT for treating prostate cancer not only shortened the treatment time but also decreased the setup uncertainty. In the setting of reducing the PTV margin to 5 mm, the dose to the prostate was compromised without IGRT but the estimated toxicity to the rectum and bladder exhibited no difference.
Original languageEnglish
Pages (from-to)285-296
Number of pages12
Journal放射治療與腫瘤學
Volume22
Issue number4
DOIs
Publication statusPublished - 2015

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Image-Guided Radiotherapy
Intensity-Modulated Radiotherapy
Prostatic Neoplasms
Rectum
Urinary Bladder
Cone-Beam Computed Tomography
Uncertainty
Prostate
Therapeutics

Keywords

  • 弧旋刀
  • 錐狀射束電腦斷層掃描
  • 等價均勻劑量
  • 正常組織併發症機率
  • Volumetric modulated arc therapy (VMAT)
  • Cone-beam computed tomography (CBCT)
  • Equivalent uniform dose (EUD)
  • Normal tissue complication probability (NTCP)

Cite this

Evaluation of thE dosimEtric and radiobiological impacts on prostatE cancEr patiEnts of daily imagE-guidEd volumEtric modulatEd arc thErapy. / Chen, Chun-You; Yu, Hsiao-Wei ; Chen, Chiu-Ping; Lin, Chi-Yeh; Chou, Chih-Cheng; Chen, Tzu-Hsin; Chen, Yi Ju; Wang, Hao; Li, Chun-I; Tsai, Chia Yi; Chen, Chia Hui; Wu, Szu-Yuan.

In: 放射治療與腫瘤學, Vol. 22, No. 4, 2015, p. 285-296.

Research output: Contribution to journalArticle

Chen, C-Y, Yu, H-W, Chen, C-P, Lin, C-Y, Chou, C-C, Chen, T-H, Chen, YJ, Wang, H, Li, C-I, Tsai, CY, Chen, CH & Wu, S-Y 2015, 'Evaluation of thE dosimEtric and radiobiological impacts on prostatE cancEr patiEnts of daily imagE-guidEd volumEtric modulatEd arc thErapy', 放射治療與腫瘤學, vol. 22, no. 4, pp. 285-296. https://doi.org/10.6316/TRO/201522
Chen, Chun-You ; Yu, Hsiao-Wei ; Chen, Chiu-Ping ; Lin, Chi-Yeh ; Chou, Chih-Cheng ; Chen, Tzu-Hsin ; Chen, Yi Ju ; Wang, Hao ; Li, Chun-I ; Tsai, Chia Yi ; Chen, Chia Hui ; Wu, Szu-Yuan. / Evaluation of thE dosimEtric and radiobiological impacts on prostatE cancEr patiEnts of daily imagE-guidEd volumEtric modulatEd arc thErapy. In: 放射治療與腫瘤學. 2015 ; Vol. 22, No. 4. pp. 285-296.
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abstract = "Purpose: Image-guided radiation therapy (IGRT) was suggested to improve outcomes and reduce toxicity for localized prostate cancer treatment. We generated virtual treatment plans to evaluate the dosimetric impacts with and without IGRT. Materials and Methods: Daily position setup errors from 10 patients treated with volumetric modulated arc therapy (VMAT) were acquired with cone-beam computed tomography (CBCT). A margin of 5 mm was added to the clinical target volume (CTV) to generate a planned target volume (PTV). We shifted the isocenters in the planning system with errors, fraction by fraction, to simulate the situation without IGRT. Dosimetric indices were compared between the initial plans (pretreatment CT plans) and the shifted plans. Radiobiological evaluations of an equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were also performed. Results : The system errors (Σ) and random errors (σ) in the left-right (LR), superiorinferior (SI), and anterior-posterior (AP) directions were Σ LR=1.4 mm, σ LR= 1.95 mm, Σ SI =3.22 mm, σ SI = 2.46 mm, Σ AP=3.17 mm and σ AP = 2.79 mm. Coverage of the CTV for 100{\%} and 95{\%} of the prescribed doses were lower in the shifted plans (V100{\%}: 99.99{\%} vs. 92.37{\%}, p < 0.05 and V95{\%}: 100{\%} vs. 99.46{\%}, p < 0.05). There was no difference in the dosimetric indices for the bladder and rectum. The EUD value of the CTV was also lower in the shifted plan (76.8 Gy vs. 75.4 Gy, p < 0.05). The EUD and NTCP for the bladder and rectum did not statistically differ. Conclusions: Using CBCT-acquired VMAT for treating prostate cancer not only shortened the treatment time but also decreased the setup uncertainty. In the setting of reducing the PTV margin to 5 mm, the dose to the prostate was compromised without IGRT but the estimated toxicity to the rectum and bladder exhibited no difference.",
keywords = "弧旋刀, 錐狀射束電腦斷層掃描, 等價均勻劑量, 正常組織併發症機率, Volumetric modulated arc therapy (VMAT), Cone-beam computed tomography (CBCT), Equivalent uniform dose (EUD), Normal tissue complication probability (NTCP), 弧旋刀 , 錐狀射束電腦斷層掃描, 等價均勻劑量, 正常組織併發症機率",
author = "Chun-You Chen and Hsiao-Wei Yu and Chiu-Ping Chen and Chi-Yeh Lin and Chih-Cheng Chou and Tzu-Hsin Chen and Chen, {Yi Ju} and Hao Wang and Chun-I Li and Tsai, {Chia Yi} and Chen, {Chia Hui} and Szu-Yuan Wu",
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volume = "22",
pages = "285--296",
journal = "放射治療與腫瘤學",
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TY - JOUR

T1 - Evaluation of thE dosimEtric and radiobiological impacts on prostatE cancEr patiEnts of daily imagE-guidEd volumEtric modulatEd arc thErapy

AU - Chen, Chun-You

AU - Yu, Hsiao-Wei

AU - Chen, Chiu-Ping

AU - Lin, Chi-Yeh

AU - Chou, Chih-Cheng

AU - Chen, Tzu-Hsin

AU - Chen, Yi Ju

AU - Wang, Hao

AU - Li, Chun-I

AU - Tsai, Chia Yi

AU - Chen, Chia Hui

AU - Wu, Szu-Yuan

PY - 2015

Y1 - 2015

N2 - Purpose: Image-guided radiation therapy (IGRT) was suggested to improve outcomes and reduce toxicity for localized prostate cancer treatment. We generated virtual treatment plans to evaluate the dosimetric impacts with and without IGRT. Materials and Methods: Daily position setup errors from 10 patients treated with volumetric modulated arc therapy (VMAT) were acquired with cone-beam computed tomography (CBCT). A margin of 5 mm was added to the clinical target volume (CTV) to generate a planned target volume (PTV). We shifted the isocenters in the planning system with errors, fraction by fraction, to simulate the situation without IGRT. Dosimetric indices were compared between the initial plans (pretreatment CT plans) and the shifted plans. Radiobiological evaluations of an equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were also performed. Results : The system errors (Σ) and random errors (σ) in the left-right (LR), superiorinferior (SI), and anterior-posterior (AP) directions were Σ LR=1.4 mm, σ LR= 1.95 mm, Σ SI =3.22 mm, σ SI = 2.46 mm, Σ AP=3.17 mm and σ AP = 2.79 mm. Coverage of the CTV for 100% and 95% of the prescribed doses were lower in the shifted plans (V100%: 99.99% vs. 92.37%, p < 0.05 and V95%: 100% vs. 99.46%, p < 0.05). There was no difference in the dosimetric indices for the bladder and rectum. The EUD value of the CTV was also lower in the shifted plan (76.8 Gy vs. 75.4 Gy, p < 0.05). The EUD and NTCP for the bladder and rectum did not statistically differ. Conclusions: Using CBCT-acquired VMAT for treating prostate cancer not only shortened the treatment time but also decreased the setup uncertainty. In the setting of reducing the PTV margin to 5 mm, the dose to the prostate was compromised without IGRT but the estimated toxicity to the rectum and bladder exhibited no difference.

AB - Purpose: Image-guided radiation therapy (IGRT) was suggested to improve outcomes and reduce toxicity for localized prostate cancer treatment. We generated virtual treatment plans to evaluate the dosimetric impacts with and without IGRT. Materials and Methods: Daily position setup errors from 10 patients treated with volumetric modulated arc therapy (VMAT) were acquired with cone-beam computed tomography (CBCT). A margin of 5 mm was added to the clinical target volume (CTV) to generate a planned target volume (PTV). We shifted the isocenters in the planning system with errors, fraction by fraction, to simulate the situation without IGRT. Dosimetric indices were compared between the initial plans (pretreatment CT plans) and the shifted plans. Radiobiological evaluations of an equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were also performed. Results : The system errors (Σ) and random errors (σ) in the left-right (LR), superiorinferior (SI), and anterior-posterior (AP) directions were Σ LR=1.4 mm, σ LR= 1.95 mm, Σ SI =3.22 mm, σ SI = 2.46 mm, Σ AP=3.17 mm and σ AP = 2.79 mm. Coverage of the CTV for 100% and 95% of the prescribed doses were lower in the shifted plans (V100%: 99.99% vs. 92.37%, p < 0.05 and V95%: 100% vs. 99.46%, p < 0.05). There was no difference in the dosimetric indices for the bladder and rectum. The EUD value of the CTV was also lower in the shifted plan (76.8 Gy vs. 75.4 Gy, p < 0.05). The EUD and NTCP for the bladder and rectum did not statistically differ. Conclusions: Using CBCT-acquired VMAT for treating prostate cancer not only shortened the treatment time but also decreased the setup uncertainty. In the setting of reducing the PTV margin to 5 mm, the dose to the prostate was compromised without IGRT but the estimated toxicity to the rectum and bladder exhibited no difference.

KW - 弧旋刀

KW - 錐狀射束電腦斷層掃描

KW - 等價均勻劑量

KW - 正常組織併發症機率

KW - Volumetric modulated arc therapy (VMAT)

KW - Cone-beam computed tomography (CBCT)

KW - Equivalent uniform dose (EUD)

KW - Normal tissue complication probability (NTCP)

KW - 弧旋刀

KW - 錐狀射束電腦斷層掃描

KW - 等價均勻劑量

KW - 正常組織併發症機率

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U2 - 10.6316/TRO/201522

DO - 10.6316/TRO/201522

M3 - Article

VL - 22

SP - 285

EP - 296

JO - 放射治療與腫瘤學

JF - 放射治療與腫瘤學

SN - 1023-988x

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