Role of IMRT in reducing penile doses in dose escalation for prostate cancer

Sethi, Anil; Mohideen, Najeeb; Leybovich, L.; Mulhall, John P.

doi:10.1016/s0360-3016(02)04164-0

Cited by 46 publications

(20 citation statements)

References 23 publications

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“…Dosimetric studies of IMRT in the treatment of prostate cancer have shown the ability to reduce radiation dose specifically to proximal penile structures such as the penile bulb. 18,[42][43][44] Radiation dose to the penile bulb has been the subject of several studies concerning radiation-induced ED. 9,10,[30][31][32] Although the results of these reports are often conflicting, there is at least some evidence to suggest that by minimizing radiation dose to the proximal penile structures, the risk of radiation-induced ED may be significantly decreased.…”

Section: Discussionmentioning

confidence: 99%

“…Rates of ED after radical prostatectomy have been reported in the literature ranging from 29 to 91%. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The rates of ED after conventional radiation therapy range from 40 to 65%, [22][23][24][25][26][27] and the rates of ED after brachytherapy range from 16 to 50%. 28 The true etiology of ED after radiation therapy remains controversial.…”

Section: Introductionmentioning

confidence: 99%

“…IMRT is a highly conformal treatment delivery technique, which allows the delivery of increased or similar tumor doses with relative sparing of normal tissues compared with conventional techniques. Sethi et al 18 showed that IMRT allowed a significant reduction in the radiation dose to proximal penile structures such as the penile bulb. With implications that the dose to the penile bulb may be associated with rates of ED after radiation treatment, 15,30 it is conceivable that the use of IMRT as a treatment modality for prostate cancer may allow for improved preservation of erectile function following radiation therapy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An analysis of erectile function after intensity modulated radiation therapy for localized prostate carcinoma

Brown

Brooks

Albert

et al. 2006

Prostate Cancer Prostatic Dis

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Radiation therapy for prostate cancer can cause erectile dysfunction (ED). Intensity Modulated Radiation Therapy (IMRT) can reduce the amount of radiation to surrounding tissues associated with ED. We characterize the incidence of and factors associated with ED in prostate cancer patients after IMRT at the National Naval Medical Center (NNMC). Patients potent by definition of the Sexual Health Inventory for Men (SHIM) before treatment completed the specific erectile questions of the SHIM after IMRT. Statistical analyses were performed to examine the relationships between several factors and ED. Thirty-two of 45 patients with mean age of 68.2 years (50-86 years) completed the SHIM. The median follow-up was 36.8 months (16-63.6 months) as defined by the time from completion of therapy to reassessment with the SHIM. Eight of 32 patients (25%) had no post-treatment ED (SHIM score 22-25), three of 32 (9%) had mild post-treatment ED (SHIM score 17-21), five of 32 (16%) had mild to moderate ED (SHIM score 12-16), five of 32 (16%) had moderate ED (SHIM score 8-11) and 11 of 32 (34%) had severe post-treatment ED (SHIM scoreo8). Posttreatment potency was significantly associated with the pre-treatment SHIM score (P ¼ 0.001) and history of hypertension (P ¼ 0.03). The mean radiation dose to the penile bulb and volume of penile bulb treated were not associated with post-treatment potency (P ¼ 0.38, 0.76, respectively). IMRT maintains potency in the majority of patients. This analysis compares favorably in preserving erectile function to previously reported series using conventional external beam radiation therapy techniques. The dose of radiation received by the penile bulb and volume of penile bulb were not associated with post-treatment ED in this analysis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An analysis of erectile function after intensity modulated radiation therapy for localized prostate carcinoma

Brown

Brooks

Albert

et al. 2006

Prostate Cancer Prostatic Dis

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“…IMRT was introduced in the treatment of PC already in 1996 resulting in a significantly lower incidence of rectal toxicity [62]. A comparison of 3DCRT and IMRT plans of 10 patients with PC showed a significantly lower radiation dose to the corporal bodies in favor of the IMRT techniques [63]. Because of a strong relationship between radiation dose in the penile bulb and ED [45], it seems warranted to limit this dose to prevent post-radiation ED.…”

Section: Prevention Of Post-radiation Edmentioning

confidence: 99%

Sexual function after external-beam radiotherapy for prostate cancer: What do we know?

Incrocci

2006

Critical Reviews in Oncology/Hematology

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“…IMRT permits dose escalation with high conformity and high dose to the prostate and while sparing normal tissues such as the bladder and rectum [2][3][4] . Moreover, IMRT results were much better as regards toxicity in comparison to three-dimensional conformal radiotherapy (3DCRT) technique plans [5][6][7] . Therefore, IMRT is being increasingly used in the treatment of prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

Dosimetric Evaluation of Advanced Radiotherapy Techniques in Treating Patients with Prostatic Cancer

Amin

Sayed

Ezzat

2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: Different radiotherapy techniques were developed to deliver optimal dose to prostate cancer while sparing nearby organs at risk (OARs). Aim: To compare different dosimetric methods used to evaluate sparing of OARs and to select radiotherapy plan which provides the most OARs sparing during prostate cancer treatment. Methods: We used computed tomography data sets of 10 patients. For each data set, six plans were calculated; two RapidArc, two intensity-modulated radiation therapy (IMRT), and two 3-dimensional conformal radiotherapy (3DCRT) plans. Isodose distribution and dose volume histograms (DVHs) were used for plan analysis and evaluation. The dose to OAR was compared by calculating the DVH for each OAR in different plans. The dose (D) delivered to certain percentage (n) of an organ (Dn) was then determined. In addition, the Critical Organ Scoring Index (COSI) and the modified COSI (mCOSI) were calculated. Results: 3DCRT with 5 fields produced the lowest rectal dose, RapidArc with bladder avoidance sector (RapidArcBladder) produced the lowest bladder dose and IMRT with 9 beams produced the lowest dose to the femoral heads. The COSI and MCOSI values of the two IMRT plans were significantly lower than those of 3DCRT and RapidArc (<0.0001). The calculation of mCOSI produced similar results to that obtained with COSI (<0.0001). Conclusion:The results of this study showed that COSI and MCOSI are better dosimetric methods in selecting the plan with more sparing of OARs than Dn. Meanwhile among advanced radiotherapy techniques, RapidArc and 3DCRT are more sparing of OARs than IMRT.

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Role of IMRT in reducing penile doses in dose escalation for prostate cancer

Cited by 46 publications

References 23 publications

An analysis of erectile function after intensity modulated radiation therapy for localized prostate carcinoma

An analysis of erectile function after intensity modulated radiation therapy for localized prostate carcinoma

Sexual function after external-beam radiotherapy for prostate cancer: What do we know?

Dosimetric Evaluation of Advanced Radiotherapy Techniques in Treating Patients with Prostatic Cancer

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