Comparison of helical tomotherapy with multi-field intensity-modulated radiotherapy treatment plans using simultaneous integrated boost in high-risk prostate cancer

Başaran, Hamit; Karaca, Sibel; Koca, Timur; Gündoğdu, Yasemin Örs

doi:10.2478/pjmpe-2021-0017

Abstract

Purpose: The aim of this study is to compare the dosimetric results of Helical Tomotherapy (HT) and Multi-field IMRT treatment plans using a Simultaneous Integrated Boost (SIB) technique in the treatment of High-Risk Prostate Cancer (HRPCa) with pelvic nodal radiation.

Methods: Seventeen patients planned with HT and 7,8 and 9 fields IMRT were investigated. All plans were designed with the prescribed dose of 54.0 Gy to the PTVln while simultaneously delivering 74.0 Gy to the PTVPS in 30 fractions. Dosimetric data of PTV and OARs were compared.

Results: HT gives a better CI and HI of PTV_PS compared to multi-field IMRT plans. HT plans significantly improved target coverage (HT:0.95 vs multi-field IMRT: 0.52, 0.49 and 0.49 respectively, p < 0.001). Bladder mean dose(Gy) (HT: 45.6 vs multi-field IMRT: 53.6, 53.3 and 52.7 respectively, p = 0.004) and D_66%(Gy) dose (HT: 35.3 vs multi-field IMRT: 46.7, 47.0 and 44.9 respectively, p = 0.006) were lower in HT. But multi-field IMRT plans significantly reduced the rectum volume receiving more than 75 Gy; (HT V_75% (%) 2.7 vs multi-field IMRT 0.8, 1.4 and 0.9 respectively, p = 0.008). HT provided better sparing of the right and left femoral head receiving a mean dose. The penile bulb and small bowel doses were the highest in HT compared with multi-field IMRT.

Conclusions: HT achieved better dose distribution to target compared to multi-field IMRT. This study suggests HT as a reasonable option for the treatment of HRPCa patients.

References

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7-30. https://doi.org/10.3322/caac.2159010.3322/caac.21590
Search in Google Scholar Back to article
2. Bray F, Ferlay J, Soerjomataram I, et al. Global cancerstatistics 2018: GLOBOCAN estimates of incidence and mortality World wide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. https://doi.org/10.3322/caac.21492. Erratum in: CA Cancer J Clin. 2020;70(4):313.10.3322/caac.21492
Search in Google Scholar Back to article
3. Kuban DA, Tucker SL, Dong L, et al. Long-termresults of the M. D. Anderson randomized dose-escalation trial for prostate cancer. Int J Radiat Oncol Biol Phys. 2008;70(1):67-74. https://doi.org/10.1016/j.ijrobp.2007.06.05410.1016/j.ijrobp.2007.06.054
Search in Google Scholar Back to article
4. Dearnaley DP, Jovic G, Syndikus I, et al. Escalated-dose versus control-dose conformal radiotherapy for prostate cancer: long-term results from the MRC RT01 randomised controlled trial. Lancet Oncol. 2014;15(4):464-73. https://doi.org/10.1016/S1470-2045(14)70040-310.1016/S1470-2045(14)70040-3
Search in Google Scholar Back to article
5. Cilla S, Deodato F, Digesù C, Macchia G, Picardi V, Ferro M, Sallustio G, De Spirito M, Piermattei A, Morganti AG. Assessing the feasibility of volumetric-modulated arc therapy using simultaneous integrated boost (SIB-VMAT): An analysis for complex head-neck, high-risk prostate and rectal cancer cases. Med Dosim. 2014 Spring;39(1):108-16. https://doi.org/10.1016/j.meddos.2013.11.001. Epub 2013 Dec 15. PMID: 24342167.10.1016/j.meddos.2013.11.001
Search in Google Scholar Back to article
6. Saracino B, Petrongari MG, Marzi S, et al. Intensity-modulated pelvic radiation therapy and simultaneous integrated boost to the prostate area in patients with high-risk prostate cancer: a preliminary report of disease control. Cancer Med. 2014;3(5):1313-1321. https://doi.org/10.1002/cam4.27810.1002/cam4.278
Search in Google Scholar Back to article
7. Pacelli R, Caroprese M, Palma G, et al. Technologicalevolution of radiationtreatment: Implications for clinical applications. Semin Oncol. 2019;46(3):193-201. https://doi.org/10.1053/j.seminoncol.2019.07.00410.1053/j.seminoncol.2019.07.004
Search in Google Scholar Back to article
8. Cuccia F, Mazzola R, Arcangeli S, et al. Moderate hypofractionated helical tomotherapy for localized prostate cancer: preliminary report of an observational prospective study. Tumori. 2019;105(6):516-523. https://doi.org/10.1177/030089161986784610.1177/0300891619867846
Search in Google Scholar Back to article
9. Morikawa LK, Roach M. Pelvic nodal radiotherapy in patients with unfavorable intermediate and high-risk prostate cancer: evidence, rationale, and future directions. Int J Radiat Oncol Biol Phys. 2011;80(1):6-16. https://doi.org/10.1016/j.ijrobp.2010.11.07410.1016/j.ijrobp.2010.11.074
Search in Google Scholar Back to article
10. Lawton CA, Michalski J, El-Naqa I, et al. RTOG GU Radiation oncology specialists reachconsensus on pelvic lymph node volumes for high-risk prostate cancer. Int J Radiat Oncol Biol Phys. 2009;74(2):383-7. https://doi.org/10.1016/j.ijrobp.2008.08.00210.1016/j.ijrobp.2008.08.002
Search in Google Scholar Back to article
11. Liang J, Wu Q, Yan D. The role of seminal vesicle motion in target margin assessment for online image-guided radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2009;73(3):935-43. https://doi.org/10.1016/j.ijrobp.2008.10.01910.1016/j.ijrobp.2008.10.019
Search in Google Scholar Back to article
12. Ramiandrisoa F, Duvergé L, Castelli J, et al. Détermination des marges du volume cible anatomoclinique au volume cible prévisionnel pour la radiothérapie du cancer prostatique [Clinical to planning target volume margins in prostate cancer radiotherapy]. Cancer Radiother. 2016 Oct;20(6-7):629-39. French. https://doi.org/10.1016/j.canrad.2016.07.09510.1016/j.canrad.2016.07.095
Search in Google Scholar Back to article
13. Piotrowski T, Kaczmarek K, Bajon T, et al. Evaluation of image-guidance strategies for prostate cancer. Technol Cancer Res Treat. 2014;13(6):583-91. https://doi.org/10.7785/tcrtexpress.2013.60025810.7785/tcrtexpress.2013.600258
Search in Google Scholar Back to article
14. Gay HA, Barthold HJ, O’Meara E, et al. Pelvic normal tissue contouring guidelines for radiationtherapy: A RadiationTherapy Oncology Group consensus panel atlas. Int J Radiat Oncol Biol Phys 2012;83:e353-e362. https://doi.org/10.1016/j.ijrobp.2012.01.02310.1016/j.ijrobp.2012.01.023
Search in Google Scholar Back to article
15. International Commission on Radiation Units and Measurements Report 83. Prescribing, recording, and reporting photon-beam intensity-modulated radiation therapy (IMRT). J ICRU 2010;10(1). https://doi.org/10.1093/jicru/ndq00210.1093/jicru/ndq002
Search in Google Scholar Back to article
16. Michalski JM, Gay H, Jackson A, Tucker SL, Deasy JO. Radiation dose-volume effects in radiation-induced rectal injury [published correction appears in Int J Radiat Oncol Biol Phys. 2019 Aug 1;104(5):1185]. Int J Radiat Oncol Biol Phys. 2010;76(3 Suppl):S123-S129. https://doi.org/10.1016/j.ijrobp.2009.03.07810.1016/j.ijrobp.2009.03.078
Search in Google Scholar Back to article
17. Wolff D, Stieler F, Welzel G, et al. Volumetric modulated arctherapy (VMAT) vs. serial tomotherapy, step-and-shoot IMRT and 3D conformal RT for treatment of prostate cancer. Radiother Oncol 2009; 93:226-233. https://doi.org/10.1016/j.radonc.2009.08.01110.1016/j.radonc.2009.08.011
Search in Google Scholar Back to article
18. Shaw E, Kline R, Gillin M, et al. Radiation Therapy Oncology Group: Radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys. 1993;27:1231-1239. https://doi.org/10.1016/0360-3016(93)90548-a10.1016/0360-3016(93)90548-A
Search in Google Scholar Back to article
19. Feuvret L, Noël G, Mazeron JJ, Bey P. Conformity index: a review. Int J Radiat Oncol Biol Phys. 2006;64(2):333-42. https://doi.org/10.1016/j.ijrobp.2005.09.02810.1016/j.ijrobp.2005.09.028
Search in Google Scholar Back to article
20. Kataria T, Sharma K, Subramani V, et al. Homogeneity Index: An objective tool for assessment of conformal radiation treatments. J Med Phys. 2012;37(4):207-213. https://doi.org/10.4103/0971-6203.10360610.4103/0971-6203.103606
Search in Google Scholar Back to article
21. Ning ZH, Mu JM, Jin JX, et al. Single arc volumetric-modulated arc therapy is sufficient for nasopharyngeal carcinoma: a dosimetric comparison with dual arc VMAT and dynamic MLC and step-and-shoot intensity-modulated radiotherapy. Radiat Oncol. 2013;8:237. https://doi.org/10.1186/1748-717X-8-23710.1186/1748-717X-8-237
Search in Google Scholar Back to article
22. Skórska M, Piotrowski T. Optimization of treatment planning parameters used in tomotherapy for prostate cancer patients. Phys Med. 2013;29(3):273-85. https://doi.org/10.1016/j.ejmp.2012.03.00710.1016/j.ejmp.2012.03.007
Search in Google Scholar Back to article
23. Cao D, Holmes TW, Afghan MK, Shepard DM. Comparison of plan quality provided by intensity-modulated arc therapy and helical tomotherapy. Int J Radiat Oncol Biol Phys. 2007;69(1):240-50. https://doi.org/10.1016/j.ijrobp.2007.04.07310.1016/j.ijrobp.2007.04.073
Search in Google Scholar Back to article
24. Tsai CL, Wu JK, Chao HL, et al. Treatment and dosimetric advantages between VMAT, IMRT, and helical tomotherapy in prostate cancer. Med Dosim. 2011;36(3):264-71. https://doi.org/10.1016/j.meddos.2010.05.00110.1016/j.meddos.2010.05.001
Search in Google Scholar Back to article
25. Rong Y, Tang G, Welsh JS, et al. Helical tomotherapy versus single-arc intensity-modulated arctherapy: a collaborative dosimetric comparison between two institutions. Int J Radiat Oncol Biol Phys. 2011;81(1):284-96. https://doi.org/10.1016/j.ijrobp.2010.10.05910.1016/j.ijrobp.2010.10.059
Search in Google Scholar Back to article
26. Ishii K, Ogino R, Okada W, et al. A dosimetric comparison of RapidArc and IMRT with hypofractionated simultaneous integrated boost to the prostate for treatment of prostate cancer. Br J Radiol. 2013;86(1030):20130199. https://doi.org/10.1259/bjr.2013019910.1259/bjr.20130199
Search in Google Scholar Back to article
27. Davidson MT, Blake SJ, Batchelar DL, et al. Assessingthe role of volumetricmodulatedarctherapy (VMAT) relative to IMRT and helical tomotherapy in the management of localized, locally advanced, and post-operative prostate cancer. Int J Radiat Oncol Biol Phys. 2011;80(5):1550-8. https://doi.org/10.1016/j.ijrobp.2010.10.02410.1016/j.ijrobp.2010.10.024
Search in Google Scholar Back to article
28. Pasquier D, Cavillon F, Lacornerie T, et al. A dosimetric comparison of tomotherapy and volumetric modulated arc therapy in the treatment of high-risk prostate cancer with pelvic nodal radiation therapy. Int J Radiat Oncol Biol Phys. 2013;85(2):549-554. https://doi.org/10.1016/j.ijrobp.2012.03.04610.1016/j.ijrobp.2012.03.046
Search in Google Scholar Back to article
29. Servagi-Vernat S, Giraud P, Fenoglietto P, et al. Apport de la RCMI rotationnelle et de la tomothérapiehélicoïdaledans les cancers pelviens : étudedosimétrique prospective sur 51 patients [Impact of dynamic IMRT and tomotherapy in pelvic cancers: a prospective dosimetric study with 51 patients]. Cancer Radiother. 2014;18(2):111-118. https://doi.org/10.1016/j.canrad.2013.12.00810.1016/j.canrad.2013.12.008
Search in Google Scholar Back to article
30. Abu-Gheida I, Reddy CA, Kotecha R, et al. Ten-Year Outcomes of Moderately Hypofractionated (70 Gy in 28 fractions) Intensity Modulated Radiation Therapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys. 2019;104(2):325-333. https://doi.org/10.1016/j.ijrobp.2019.01.09110.1016/j.ijrobp.2019.01.091
Search in Google Scholar Back to article
31. Widesott L, Pierelli A, Fiorino C, et al. Helical tomotherapy vs. intensity-modulated proton therapy for whole pelvis irradiation in high-risk prostate cancer patients: dosimetric, normal tissue complication probability, and generalized equivalent uniform dose analysis. Int J Radiat Oncol Biol Phys. 2011;80(5):1589-1600. https://doi.org/10.1016/j.ijrobp.2010.10.00510.1016/j.ijrobp.2010.10.005
Search in Google Scholar Back to article
32. Barelkowski T, Wust P, Kaul D, et al. Image-guided dose-escalated radiation therapy for localized prostate cancer with helical tomotherapy. Strahlenther Onkol. 2020;196(3):229-242. https://doi.org/10.1007/s00066-019-01562-210.1007/s00066-019-01562-2
Search in Google Scholar Back to article
33. Beck M, Wust P, Barelkowski T, et al. Risk adapted dose-intensified postoperative radiation therapy in prostate cancer patients using a simultaneous integrated boost technique applied with helical Tomotherapy. Radiat Oncol. 2017;12(1):125. https://doi.org/10.1186/s13014-017-0862-410.1186/s13014-017-0862-4
Search in Google Scholar Back to article

Comparison of helical tomotherapy with multi-field intensity-modulated radiotherapy treatment plans using simultaneous integrated boost in high-risk prostate cancer

Abstract

Paradigm

My account