Dose-escalation using intensity-modulated radiotherapy for prostate cancer – Evaluation of the dose distribution with and without 18F-choline PET-CT detected simultaneous integrated boost
| Autor: | Richard Holy, Michael Pinkawa, Sandra Nussen, Jens Klotz, Marc D. Piroth, Wolfgang Schäfer, Robert Hawickhorst, Michael J. Eble, Charbel Attieh |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Fluorine Radioisotopes Rectum Choline Lesion Prostate cancer Therapeutic index Prostate medicine Humans Radiology Nuclear Medicine and imaging Radiation treatment planning Aged PET-CT business.industry Radiotherapy Planning Computer-Assisted Prostatic Neoplasms Radiotherapy Dosage Hematology Middle Aged medicine.disease medicine.anatomical_structure Oncology Positron-Emission Tomography Prostate neoplasm Radiotherapy Intensity-Modulated medicine.symptom Tomography X-Ray Computed Nuclear medicine business |
| Zdroj: | Radiotherapy and Oncology. 93:213-219 |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2009.07.014 |
| Popis: | The aim of the study was to evaluate the impact of a dose escalation to an (18)F-choline PET-CT defined simultaneous integrated boost (IB) on the dose distribution and changes of the equivalent uniform dose (EUD).PET-CT was performed in 12 consecutive patients for treatment planning. An intraprostatic lesion was defined by a tumour-to-background uptake value ratio2 (GTV(PET)). Dose escalation was focused only on the intraprostatic lesion. Two comparisons were evaluated: whole prostate irradiation to 76 Gy+/-boost to 80 Gy (C1) and whole prostate irradiation to 66.6 Gy+/-boost to 83.25 Gy (C2).PTV/GTV(PET)+margins were covered by a mean EUD of 75.9/76.1 Gy vs. 77.1/80.1 Gy (C1) and 66.5/66.2 Gy vs. 71.1/82.9 Gy (C2) (p0.01, respectively). Concerning the organs at risk, EUD increased slightly with an additional boost (mean EUD for bladder: C1 53.2 Gy vs. 53.8 Gy; C2 43.0 Gy vs. 45.1 Gy; for rectum: C1 52.0 Gy vs. 52.6 Gy; C2 43.0 Gy vs. 45.4 Gy; p0.01, respectively). The distance to the organs at risk had a significant impact on the respective maximum doses in the treatment plans with IB.Treatment planning with IB allows an individually adapted dose escalation. The therapeutic ratio can be improved by a considerable dose escalation to the macroscopic tumour, but only minor EUD changes to the bladder and rectum. |
| Databáze: | OpenAIRE |
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