| Popis: |
BackgroundWe aimed to assess the feasibility of a novel dose painting (DP) procedure for treating prostate cancer with dominant intraprostatic lesions (DILs) based on mpMR images and hierarchical clustering with a machine learning technique. MethodsThe mpMR images of 120 patients were used to create hierarchical clustering and draw a dendrogram. Three clusters were selected for performing agglomerative clustering. Then, the DIL acquired from the mpMR images of 20 patients were categorized into three groups to have them treated with a novel DP procedure being composed of three planning target volumes (PTVs) determined as PTV1, PTV2, and PTV3 in treatment plans. The DP procedure was carried out on the patients wherein a total dose of 80, 85, and 91 Gy were delivered to the PTV1, PTV2, and PTV3, respectively. Dosimetric and radiobiologic parameters (TCP & NTCP) of the DP procedure were compared with those of the conventional IMRT and 3DCRT procedures carried out on another group of 20 patients. A post-treatment follow-up was also made four months after the radiotherapy procedures.ResultsAll the dosimetric variables and the NTCPs of the organs at risks revealed no significant difference between the DP and IMRT procedures. Regarding the TCP of three investigated PTVs, significant differences were observed between the DP vs. IMRT and also DP vs. 3DCRT procedures. At post-treatment follow-up, the DIL volumes and ADC values in the DP group differed significantly (p-value0.05) between the DP vs. IMRT. ConclusionsThe results of this comprehensive clinical trial illustrated the feasibility of our novel DP procedure for treating prostate cancer based on mpMR images validated with acquired patients’ dosimetric and radiobiologic assessment and their follow-ups. This study confirms significant potential of the proposed DP procedure as a promising treatment planning to achieve effective dose escalation and treatment for prostate cancer.Trial registrationIRCT20181006041257N1; Iranian Registry of Clinical Trials, Registered: 23 Oct. 2019, https://en.irct.ir/trial/34305 |
