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[Adaptive IG-IMRT for prostate cancer].

J Vanásek1, K Odrázka, M Dolezel

  • 1Oddelení klinické a radiacní onkologie, Multiscan s.r.o., Pardubická krajská nemocnice a.s., Pardubice. vanasek@multiscan.cz

Klinicka Onkologie : Casopis Ceske a Slovenske Onkologicke Spolecnosti
|November 11, 2011
PubMed
Summary

Adaptive image-guided intensity-modulated radiation therapy (IG-IMRT) for prostate cancer is effective. This protocol, using kilovoltage cone-beam CT (CBCT), ensures accurate target coverage and allows for margin reduction, paving the way for dose escalation.

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Area of Science:

  • Radiation Oncology
  • Medical Imaging

Background:

  • Adaptive image-guided intensity-modulated radiation therapy (IG-IMRT) shows promise for localized prostate cancer treatment.
  • Optimal protocols for IG-IMRT using kilovoltage cone-beam CT (CBCT) require validation.

Purpose of the Study:

  • To validate an adaptive IG-IMRT protocol for prostate cancer using CBCT.
  • To determine optimal safety margins based on systematic and random errors.

Main Methods:

  • Seventy-six prostate cancer patients underwent adaptive IG-IMRT.
  • Prostate position was determined using CBCT during the initial radiotherapy fractions.
  • Treatment plans were adapted based on average prostate position and random error (sigma).
  • Daily patient setup used kilovoltage skiagraphic imaging (kV-kV), with weekly follow-up CBCTs.

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Main Results:

  • 83% of patients (63/76) showed an average isocenter shift in at least one axis.
  • The planning target volume (PTV) margins were adjusted to 6-10 mm (AP), 6-8 mm (SI), and 6 mm (RL).
  • Setup errors exceeding the CTV-PTV margin occurred in only 4 cases (5%), with a 95% sufficient safety margin.

Conclusions:

  • The IG-IMRT protocol, integrating CBCT and kV-kV imaging, ensures adequate target volume coverage.
  • This protocol is compatible with departmental workflow and enables margin reduction for dose escalation.