The Evaluation of Differences of 3D-CRT, IMRT and VMAT Radiotherapy Planning for Prostate Cancer

以3D-CRT, IMRT及VMAT治療計畫評估攝護腺癌治療劑量研究

Than Van Viet；Jao-Perng Lin；Tran Van Viet；Yi-Chi Liu；Nguyen Tuan Anh

PTV ； OARs ； Prostate Cancer ； Dosimetry ； 3D-CRT ； IMRT ； VMAT

台灣應用輻射與同位素雜誌

14卷4期（2018 / 12 / 01）

1665 - 1672

英文

Nowadays, radiation therapy comes to the standard treatment for prostate cancer. There are many critical Organ at Risks (OARs) can be affected during and after the treatment, which can negatively affect patients' later life. In our study, we made comparisons in terms of the optimal dose to target as well as sparing dose to OARs among three techniques 3D-CRT, IMRT and VMAT of prostate cancer. Ten of prostate cancer patients after being treated by IMRT were recruited. The dose influence in PTV was evaluated by Homogeneity index (HI) and Conformation index (CI). Monitor units (MUs) and treatment time (TT) were compared. Three treatment planning met the target coverage (over 95% prescription) and dose distribution. However, IMRT and VMAT showed the optimal dose in mean dose in the target, p＜0.05. Besides, distribution dose in OARs of IMRT and VMAT was significantly lower comparing with 3D-CRT planning, p＜0.05. MU of IMRT (793.4±37.2) planning illustrated higher than 3D-CRT (305.5±19.80) and VMAT (483.8±21.3). VMAT planning was successful in reducing MU and treatment time. Our study demonstrated that VMAT planning was significantly better in planning quality compared with 3D-CRT and IMRT in the optimal dose to target, OARs and treatment time.

1. (2010).The International Commission on Radiation Units and Measurements.Journal of the ICRU Report,10
2. Aoki, J,Kirtane, A,Leon, MB(2008).Coronary artery aneurysms after drug-eluting stent implantation.JACC Cardiovascular Intervention,1,14-21.
3. Ashman, JB,Zelefsky, MJ,Hunt, MS(2005).Whole pelvic radiotherapy for prostate cancer using 3D conformal and intensitymodulated radiotherapy.Int J Radiat Ooncol Biol Phys,63,765-771.
4. Boersma, LJ,van den Brink, M,Bruce, AM,Shouman, T,Gras, L,te Velde, A,Lebesque, JV(1998).Estimation of the incidence of late bladder and rectum complications after high-dose (70-78 GY) conformal radiotherapy for prostate cancer, using dose-volume histograms.Int J Radiat Oncol Biol Phys,41,83-92.
5. Bortfeld, T,Webb, S(2009).Single Arc IMRT?.Phys Med Biol,54,9-20.
6. Cahlon, O,Zelefsky, MJ,Shippy, A(2008).Ultra-high dose (86.4Gy) IMRT for localized prostate cancer: toxicity and biochemical outcomes.Int J Radiat Oncol Biol Phys,71,330-337.
7. Cakir, Aydin,Akgun, Zuleyha,Fayda, Merdan,Agaoglu, Fulya(2004).Comparison of Three Dimensional Conformal Radiation Therapy, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy for Low Radiation Exposure of Normal Tissue in Patients with Prostate Cancer.Asian Pac J Cancer Prev,16(8),3365-3370.
8. Cozzi, L,Dinshaw, KA,Shrivastava, SK(2008).A treatment planning study comparing volumetric arc modulation with RapidArc and fixed field IMRT for cervix uteri radiotherapy.Radiother Oncol.,89(2),180-191.
9. Dearnaley, DP,Sydes, MR,Graham, JD,Aird, EG,Bottomley, D,Cowan, RA,Huddart, RA,Jose, CC,Matthews, JH,Millar, J(2007).Escalated-dose versus standard-dose conformal radiotherapy in prostate cancer: First results from the MRC RT01 randomised controlled trial.Lancet Oncol,8,475-487.
10. Elith, CA,Cao, F,Dempsey, SE,Findlay, N,Warren-Forward, HA(2013).Retrospective planning analysis comparing volumetric-modulated arc therapy (VMAT) to ntensity-modulated radiation therapy (IMRT) for radiotherapy treatment of prostate cancer.JMIRS,44,79-86.
11. Followill, DS,Stovall, MS,Kry, SF,Ibbott, GS(2008).Neutron source trength measurements for Varian, Siemens, Elekta and General Electric linear aacelerators.J Appl Clin Med Phys,4,189-194.
12. Freedman, GM,Anderson, PR,Li, J(2006).Intensity modulated radiation therapy (IMRT) decreases acute skin toxicity for women receiving radiation for breast cancer.Am J Clin Oncol,29,66-70.
13. Hall, EJ(2006).Intensity-modulated radiation therapy, protons, and the risk of second cancers.Int J Radiat Ooncol Biol Phys,65,1-7.
14. Mock, U,Georg, D,Bogner, J(2004).Treatment planning comparison of conventional, 3D conformal, and intensity-modulated photon (IMRT) and proton therapy for paranasal sinus carcinoma.Int J Radiat Ooncol Biol Phys,58,147-154.
15. Otto, K(2008).Volumetric modulated arc therapy: IMRT in a single gantry arc.Med Phys,35,310-317.
16. Palma, D,Vollans, E,James, K(2008).Volumetric modulated arc therapy for delivery of prostate radiotherapy: Comparison with intensity-modulated radiotherapy and three-dimensional conformal radiotherapy.Int J Radiat Oncol Biol Phys,72,996-1001.
17. Pasquier, D,Cavillon, F,Lacornerie, T(2013).A dosimetric comparison of tomotherapy and volumetric modulated arc therapy in the treatment of high-risk prostate cancer with pelvic nodal radiation therapy.Int J Radia Oncol Bio Phys,85,549-554.
18. Peeters, ST,Heemsbergen, WD,Koper, PC,van Putten, WL,Slot, A,Dielwart, MF,Bonfrer, JM,Incrocci, L,Lebesque, JV(2006).Dose-response in radiotherapy for localized prostate cancer: Results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy.J Clin Oncol,24,1990-1996.
19. Peeters, ST,Heemsbergen, WD,van Putten, WL(2005).Acute and late complications after radiotherapy for prostate cancer: results of a multicenter randomized trial comparing 68 Gy to 78 Gy.Int J Radiat Oncol Biol Phys,61,1019-1034.
20. Pollack, A.,Zagars, G.K.,Starkschall, G.(2002).Prostate cancer radiation dose response: results of the M. D. Anderson phase III randomized trial.Int. J. Radiat. Oncol. Biol. Phys.,53,1097-1105.
21. Pollack, A,Zagars, GK,Smith, LG(2000).Preliminary results of a randomized radiotherapy dose-escalation study comparing 70 Gy with 78 Gy for prostate cancer.J Clin Oncol,18,3904-3911.
22. Schoenhagen, P,Ziada, KM,Vince, DG(2001).Arterial remodeling and coronary artery disease: the concept of “dilated” versus “obstructive” coronary atherosclerosis.Journal of the American College of Cardiology,38,297-306.
23. Shaw, E.G.,Wang, M.,Coons, S.,Brachman, D.,Buckner, J.C.,Stezer, K.(2008).Final report of Radiation Therapy Oncology Group (RTOG).Journal of Clinical Oncology,26
24. Shepard, DM,Cao, D,Afghan, MK(2007).An arc-sequencing algorithm for intensity modulated arc therapy.Med Phys,34,464-470.
25. Sountoulides, P,Koletsas, N,Kikidakis, D(2007).Secondary malignancies following radiotherapy for prostate cancer.Ther Adv Urol,2,119-125.
26. Trofimov, A,Nguyen, PL,Coen, JJ(2007).Radiotherapy treatment of early-stage prostate cancer with IMRT and protons: A treatment planning comparison.Int J Radiat Ooncol Biol Phys,69,444-453.
27. Tsai, CL,Wu, JK,Chao, HL,Tsai, YC(2011).Treatment and dosimetric advantages between VMAT, IMRT, and helical tomotherapy in prostate cancer.Medical Dosimetry,36,264-271.
28. Wu, VW,Kwong, DL,Sham, JS(2004).Target dose conformity in 3-dimensional conformal radiotherapy and intensity modulated radiotherapy.Radiother Oncol,71,201-206.
29. Wu, VW,Kwong, DL,Sham, JS(2007).Target dose conformity in 3-dimensional conformal radiotherapy and intensity modulated radiotherapy.Radiother Oncol,71,201-206.
30. Yu, CX,Li, XA,Ma, L(2012).Clinical implementation of intensity-modulated arc therapy.Int J Radiat Oncol Biol Phys,53,453-463.
31. Yu, CX,Li, XA,Ma, L(2002).Clinical implementation of intensity-modulated arc therapy.Int J Radiat Oncol Biol Phys,53,453-463.
32. Zelefsky, MJ,Fuks, Z,Happersett, L(2000).Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer.Radiother Oncol,55,241-249.
33. Zietman, A.L.,DeSilvio, M.L.,Slater, J.D.(2005).Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial.JAMA,9,1233-1239.
34. Zietman, AL,DeSilvio, ML,Slater, JD,Rossi, CJ, Jr,Miller, DW,Adams, JA,Shipley, WU(2005).Comparison of conventional-dose vs high-dose conformal radiationtherapy in clinically localized adenocarcinoma of the prostate: A randomized controlled trial.JAMA,294,1233-1239.