Dosimetric comparison of intensity-modulated solutions for intact prostate cancer

The purpose of this study is intended to investigate the implementation of a modified class solution for intact prostate intensity-modulated radiation therapy (IMRT). The class solution uses 2 additional optimization structures intended to increase target conformity and decrease unnecessary dose to healthy tissue. A total of 10 randomly selected intact prostate IMRT patients were chosen for this retrospective study. Each of the original IMRT plans was compared with a modified class solution. The class solution implemented 2 additional optimization structures. The 95_OPT was intended to increase target conformity, and the Avoidance_3780 was intended to reduce normal tissue. Each plan was evaluated for minimum, maximum, and mean doses to the target. Additionally, mean normal tissue dose, total monitor units (MUs), and segments were investigated. Conformity index and normal healthy index were also compared. All comparisons were evaluated using a paired t-test using GraphPad software. Evaluations of MUs; segments; minimum, maximum, mean target doses; mean normal tissue dose; and conformity index did not demonstrate a significant difference between the modified class solution and the original plans. However, evaluation of healthy tissue conformity index indicated a significant difference. Overall, 70% of the original plans failed to demonstrate a satisfactory score (< 0.6) of properly sparing normal healthy tissue, whereas 70% of the modified plans exhibited a satisfactory score (> 0.6). Most (90%) of the modified plans demonstrated a greater number of segments than the compared original plan. A modified class solution provides a good starting point for planning intact prostate cancer. The addition of the Avoidance_3780 structure increases the healthy tissue conformity index score.