Defining the potential for sexual structures-sparing for prostate cancer external beam radiotherapy: A dosimetric study.

Autor: Le Guevelou J; Department of Radiotherapy, centre Eugène-Marquis, 35000 Rennes, France. Electronic address: jennifer.leguevelou@gmail.com., Houssayni A; Université de Rennes, Inserm, LTSI, UMR 1099, 35000 Rennes, France., Key S; Department of Radiotherapy, centre Eugène-Marquis, 35000 Rennes, France., Largent A; Université de Rennes, Inserm, LTSI, UMR 1099, 35000 Rennes, France., Lafond C; Department of Physics, centre Eugène-Marquis, 35000 Rennes, France., Acosta O; Université de Rennes, Inserm, LTSI, UMR 1099, 35000 Rennes, France., Simon A; Université de Rennes, Inserm, LTSI, UMR 1099, 35000 Rennes, France., de Crevoisier R; Department of Radiotherapy, centre Eugène-Marquis, 35000 Rennes, France., Barateau A; Department of Physics, centre Eugène-Marquis, 35000 Rennes, France.
Jazyk: angličtina
Zdroj: Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique [Cancer Radiother] 2024 Dec; Vol. 28 (8), pp. 686-692. Date of Electronic Publication: 2024 Nov 08.
DOI: 10.1016/j.canrad.2024.05.008
Abstrakt: Purpose: The purpose of the study was to evaluate the dosimetric impact of sexual-sparing radiotherapy for prostate cancer, with magnetic resonance-only treatment planning.
Material and Methods: Fifteen consecutive patients receiving prostate cancer radiotherapy were selected. A synthetic CT was generated with a deep learning method from each T2-weighted MRI performed at the time of treatment planning. For each patient, two plans were performed: standard treatment planning and sexual-structures sparing treatment planning. The treatment plan was designed to deliver a dose of 78Gy to the prostate and 50Gy to the seminal vesicles in 2Gy daily fractions, using volumetric arc therapy. Dose-volume histograms were computed to compare treatment plans.
Results: All plans fulfilled dosimetric objectives and were equivalent regarding planning target volume coverage. The doses delivered to both rectum, bladder, and femoral heads were similar between plans (P=0.20). Sexual-sparing plans enabled to decrease all dosimetric parameters on sexual organs-at-risk. The mean penile bulb dose in sexual-sparing plans was significantly reduced (21.1Gy±20.7 versus 13.4Gy±14.0, P<0.01), however with large variability observed between individuals. The mean dose delivered to the corpora cavernosa was also significantly reduced within sexual-sparing plans (13.1Gy±16.7 versus 8.6Gy±10.4, P<0.01). A significant reduction was also observed in the highest doses delivered to internal pudendal arteries (D10%: 48.4Gy±8.3 versus 33.1Gy±4.6, P<0.05; D5%: 52.0Gy±8.7 versus 36.8Gy±5.5, P<0.05).
Conclusion: Sparing of sexual structures appears feasible, without compromising neither planning target volume coverage nor doses delivered to non-sexual organs at risk. The clinical significance of this dose-reduction requires prospective evaluation.
(Copyright © 2024 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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