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Published on: February 6, 2019
Rotational radiotherapy for prostate cancer in clinical practice
Marianne C Aznar1, Peter Meidahl Petersen, Ashildur Logadottir
1Department of Radiation Oncology, Rigshospitalet, Copenhagen, Denmark. marianne.aznar@rh.regionh.dk
Summary
Rotational radiotherapy (RA) offers improved rectal sparing and reduced treatment time for prostate cancer patients compared to Intensity Modulated Radiation Therapy (IMRT). This advanced technique also decreases intra-fractional prostate motion, enhancing treatment accuracy.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Radiotherapy is a standard treatment for locally advanced prostate cancer.
- Modulated rotational radiotherapy represents a technological advancement, delivering precise doses with reduced beam-on time.
Purpose of the Study:
- To compare the efficacy and safety of rotational radiotherapy (RapidArc®) with Intensity Modulated Radiation Therapy (IMRT) in prostate cancer patients.
- To evaluate dosimetric parameters, treatment time, and intra-fractional prostate motion between the two techniques.
Main Methods:
- A retrospective analysis of 46 prostate cancer patients treated with RapidArc® (RA) compared to 50 patients treated with 5-field IMRT.
- Comparison included target coverage, organ-at-risk (OAR) doses, treatment duration, and monitor units.
- Daily image-guided radiotherapy (IGRT) with gold markers assessed intra-fractional prostate displacement.
Main Results:
- RA demonstrated superior rectal sparing and achieved desired dose distributions with fewer monitor units and significantly shorter treatment times (1.1 min vs. 4.9 min).
- RA treatment led to a reduction in intra-fractional prostate motion (from 16.7% to 4.7%) due to decreased treatment time.
- Slight side-effects were observed in both groups, though RA showed increased dose to femoral heads.
Conclusions:
- RapidArc® provides improved rectal sparing and significantly reduces treatment time in prostate cancer radiotherapy, thereby minimizing prostate motion.
- While effective, rotational radiotherapy may increase radiation dose to the femoral heads, necessitating careful consideration.
