Ultrahypofractionated radiotherapy for localized prostate cancer with simultaneous boost to the dominant intraprostatic lesion: a plan comparison

Ultrahypofractionated radiotherapy for localized prostate cancer with simultaneous boost to the dominant intraprostatic lesion: a plan comparison

Objective: To compare different stereotactic body techniques—intensity-modulated radiotherapy with photons and protons, applied to radiotherapy of prostatic cancer—with simultaneous integrated boost (SIB) on the dominant intraprostatic lesion (DIL). Methods: Ten patients were selected for this plann...

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Published in:Tumori Vol. 108; no. 3; pp. 263 - 269
Main Authors: Cambria, Raffaella, Ciardo, Delia, Bazani, Alessia, Pansini, Floriana, Rondi, Elena, Maestri, Davide, Zerini, Dario, Marvaso, Giulia, Romanelli, Pola, Timon, Giorgia, Fodor, Cristiana, Petralia, Giuseppe, Alessi, Sarah, Pricolo, Paola, Vischioni, Barbara, Fossati, Piero, Molinelli, Sivia, Russo, Stefania, Ciocca, Mario, De Cobelli, Ottavio, Renne, Giuseppe, Orecchia, Roberto, Cattani, Federica, Jereczek-Fossa, Barbara A.
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01-06-2022
Subjects:
dominant intraprostatic lesion
stereotactic body radiotherapy
proton therapy
IMPT
Prostate cancer
SBRT
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Summary:Objective: To compare different stereotactic body techniques—intensity-modulated radiotherapy with photons and protons, applied to radiotherapy of prostatic cancer—with simultaneous integrated boost (SIB) on the dominant intraprostatic lesion (DIL). Methods: Ten patients were selected for this planning study. Dosimetric results were compared between volumetric modulated arc therapy, intensity-modulated radiation therapy (IMRT), and intensity-modulated proton therapy both with two (IMPT 2F) and five fields (IMPT 5F) planning while applying the prescription schemes of 7.25 Gy/fraction to the prostate gland and 7.5 Gy/fraction to the DIL in 5 fractions. Results: Comparison of the coverages of the planning target volumes showed that small differences exist. The IMPT-2F-5F techniques allowed higher doses in the targets; conformal indexes resulted similar; homogeneity was better in the photon techniques (2%–5%). Regarding the organs at risk, all the techniques were able to maintain the dose well below the prescribed constraints: in the rectum, the IMPT-2F-5F and IMRT were more efficient in lowering the intermediate doses; in the bladder, the median dose was significantly better in the case of IMPT (2F–5F). In the urethra, the best sparing was achieved only by IMPT-5F. Conclusions: Stereotactic radiotherapy with SIB for localized prostate cancer is feasible with all the investigated techniques. Concerning IMPT, the two-beam technique does not seem to have a greater advantage compared to the standard techniques; the 5-beam technique seems more promising also accounting for the range uncertainty.
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ISSN:0300-8916
2038-2529
DOI:10.1177/03008916211011667