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Dosimetric advantages of daily adaptive strategy in IMPT for high-risk prostate cancer

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Title: Dosimetric advantages of daily adaptive strategy in IMPT for high-risk prostate cancer
Authors: Tamura, Hiroshi Browse this author
Kobashi, Keiji Browse this author
Nishioka, Kentaro Browse this author →KAKEN DB
Yoshimura, Takaaki Browse this author
Hashimoto, Takayuki Browse this author →KAKEN DB
Shimizu, Shinichi Browse this author
Ito, Yoichi M. Browse this author →KAKEN DB
Maeda, Yoshikazu Browse this author
Sasaki, Makoto Browse this author
Yamamoto, Kazutaka Browse this author
Tamamura, Hiroyasu Browse this author
Aoyama, Hidefumi Browse this author →KAKEN DB
Shirato, Hiroki Browse this author →KAKEN DB
Keywords: adaptive therapy
intensity-modulated proton therapy
prostate cancer
robust optimization
Issue Date: Apr-2022
Publisher: John Wiley & Sons
Journal Title: Journal of applied clinical medical physics
Volume: 23
Issue: 4
Start Page: e13531
Publisher DOI: 10.1002/acm2.13531
Abstract: Purpose To evaluate the dosimetric advantages of daily adaptive radiotherapy (DART) in intensity-modulated proton therapy (IMPT) for high-risk prostate cancer by comparing estimated doses of the conventional non-adaptive radiotherapy (NART) that irradiates according to an original treatment plan through the entire treatment and the DART that uses an adaptive treatment plan generated by using daily CT images acquired before each treatment. Methods Twenty-three patients with prostate cancer were included. A treatment plan with 63 Gy (relative biological effectiveness (RBE)) in 21 fractions was generated using treatment planning computed tomography (CT) images assuming that all patients had high-risk prostate cancer for which the clinical target volume (CTV) needs to include prostate and the seminal vesicle (SV) in our treatment protocol. Twenty-one adaptive treatment plans for each patient (total 483 data sets) were generated using daily CT images, and dose distributions were calculated. Using a 3 mm set-up uncertainty in the robust optimization, the doses to the CTV, prostate, SV, rectum, and bladder were compared. Results Estimated accumulated doses of NART and DART in the 23 patients were 60.81 +/- 3.47 Gy (RBE) and 63.24 +/- 1.04 Gy (RBE) for CTV D99 (p < 0.01), 62.99 +/- 1.28 Gy (RBE) and 63.43 +/- 1.33 Gy (RBE) for the prostate D99 (p = 0.2529), and 59.07 +/- 5.19 Gy (RBE) and 63.17 +/- 1.04 Gy (RBE) for SV D99 (p < 0.001). No significant differences were observed between NART and DART in the estimated accumulated dose for the rectum and bladder. Conclusion Compared with the NART, DART was shown to be a useful approach that can maintain the dose coverage to the target without increasing the dose to the organs at risk (OAR) using the 3 mm set-up uncertainty in the robust optimization in patients with high-risk prostate cancer.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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