Image-guided radiotherapy for prostate cancer

Pinkawa, Michael; Pursch-Lee, Martin; Asadpour, Branka; Gagel, Bernd; Piroth, Marc D.; Klotz, Jens; Nussen, Sandra; Eble, Michael J.

doi:10.1007/s00066-008-1902-7

Cited by 54 publications

(19 citation statements)

References 30 publications

(28 reference statements)

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“…Furthermore it is essential while in the case of the 3DCRT at a correct setup of the patient always the whole PTV is inside of the field, in the case of IMRT between segments, which should complement one another there might result an overlap or gap due to intrafractional movements. Interfractional movements are no particular problem of IMRT and the treatment accuracy can be improved by image guidance [1,19,23,24,27].…”

Section: Discussionmentioning

confidence: 99%

“…Thereby image guidance is recommended to reduce errors of patient setup and internal motion of the prostate [12,19,24,25].Different algorithms for the optimisation have been described. Two systematically different procedures are applied generally: the first begins with searching for the ideal fluence and then subsequentely creates segments for the multileaf collimator (MLC).…”

Section: Background and Purposementioning

confidence: 99%

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IMRT of prostate cancer

Treutwein

Hipp²,

Kölbl³

et al. 2009

Strahlenther Onkol

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Background and Purpose: Intensity-modulated radiation therapy (IMRT) has shown its superiority to 3D conformal radiotherapy in the treatment of prostate cancer. Different optimisation algorithms are available: algorithms which first optimise the fluence followed by a sequencing (IM) and algorithms which involve the machine parameters directly in the optimisation process (DSS). The aim of this treatment planning study is to compare both of them regarding dose distribution and treatment time.Patients, Material and Methods: Ten consecutive patients with localized prostate cancer were enrolled for this planning study. The planning target volume (PTV) and the rectum volume, urinary bladder and femoral heads as organs at risk (OAR) were delineated. Average doses, the target dose homogeneity H, D 5 , D 95 , monitor units per fraction and the number of segments were evaluated. Results:While there is only a small difference in the mean doses at rectum and bladder, there is a significant advantage for the target dose homogeneity in the DSS-optimised plans compared to the IMoptimised ones. Differences in the monitor units (nearly 10% less for DSS) and the number of segments are also statistically significant and reduce the treatment time. Conclusion:Particularly with regard to the tumor control probability the better homogeneity of the DSS-optimised plans is more profitable. The shorter treatment time is an improvement regarding intrafractional organ motion. The DSS-optimiser results in a higher target dose homogeneity and, simultaneously, in a lower number of monitor units. Therefore it should be preferred for IMRT of prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Background and Purposementioning

confidence: 99%

IMRT of prostate cancer

Treutwein

Hipp²,

Kölbl³

et al. 2009

Strahlenther Onkol

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“…Thus, today IMRT is the gold-standard treatment for radiotherapy (RT) of PCA [10,28]. To account for the interfractional and intrafractional movement of the prostate [13,21,22,29], image guidance was shown to be essential to avoid large safety margins around the clinical target volume (CTV). This report presents the pretreatment GI and genitourinary (GU) morbidity (PGUM) rates as well as acute and late GI/GU toxicity and early biochemical control data of 102 patients treated using high-dose IMRT with daily image-guidance.…”

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confidence: 99%

High-Dose (80 Gy) Intensity-Modulated Radiation Therapy with Daily Image-Guidance as Primary treatment for Localized Prostate Cancer

et al. 2010

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“…For IMRT and HT, the PTV definition had to consider the intrafraction movements of the prostate and the setup uncertainties before treatment using the most modern IGRT techniques [21,26]. These prostatic intrafraction motions required a safety margin of 4 mm from the prostate [1,22].…”

Section: Ctv-ptv Expansionsmentioning

confidence: 99%