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Comparing Efficacy Between Robust and PTV Margin-based Optimizations for Interfractional Anatomical Variations in

Takayuki Yagihashi1,2, Tatsuya Inoue3,4, Shintaro Shiba5

  • 1Department of Medical Physics, Shonan Kamakura General Hospital, Kanagawa, Japan.

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Summary

Robust optimization improves prostate cancer radiotherapy by accounting for anatomical variations, leading to better target coverage and rectal dose sparing in helical tomotherapy compared to planning target volume (PTV) margin-based plans.

Keywords:
Daily MVCTRayStationhelical tomotherapyinterfractional anatomical variationsprostate cancerrobust optimization

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Area of Science:

  • Radiation oncology
  • Medical physics
  • Cancer treatment

Background:

  • Anatomical variations between planned and actual radiotherapy doses can significantly impact treatment efficacy.
  • Helical tomotherapy for prostate cancer requires precise dose delivery to overcome interfractional uncertainties.

Purpose of the Study:

  • To evaluate the effectiveness of robust optimization versus planning target volume (PTV) margin-based optimization.
  • To assess these methods in managing anatomical variations during helical tomotherapy for prostate cancer.

Main Methods:

  • Ten prostate cancer patients underwent kVCT and daily MVCT scans.
  • Nominal treatment plans were created using robust and PTV margin-based optimizations.
  • Daily doses were recalculated considering patient setup errors and dose corrections (1-3%) using MVCT data.

Main Results:

  • Robust plans showed superior dose conformity and homogeneity compared to PTV plans in nominal settings.
  • In dose-corrected scenarios, robust plans significantly improved target coverage and rectal dose sparing.
  • Dose conformity and homogeneity remained consistent with nominal plans across scenarios.

Conclusions:

  • Robust optimization is recommended for helical tomotherapy in prostate cancer.
  • This approach effectively addresses anatomical variations, enhancing target coverage and organ-at-risk sparing.