Abstract:
BACKGROUND:Image-guided radiation therapy (IGRT) is the preferred method for curative treatment of localized prostate cancer, which could improve disease outcome and reduce normal tissue toxicity reaction. IGRT using cone-beam computed tomography (CBCT) in combination with volumetric-modulated arc therapy (VMAT) potentially allows smaller treatment margins and dose escalation to the prostate. The aim of this study was to compare the difference of dosimetric diffusion in conventional IGRT using 7-field, step-and-shoot intensity-modulated radiation therapy (IMRT) and hypofractionated IGRT using VMAT for patients with localized prostate cancer. METHODS:We studied 24 patients who received 78 Gy in 39 daily fractions or 70 Gy in 28 daily fractions to their prostate with/without the seminal vesicles using IMRT (n = 12) or VMAT (n = 12) for prostate cancer between November 2013 and October 2015. Image guidance was performed using kilovoltage CBCT scans equipped on the linear accelerator. Offline planning was performed using the daily treatment images registered with simulation computed tomography (CT) images. A total of 212 IMRT plans in conventional cohort and 292 VMAT plans in hypofractionated cohort were enrolled in the study. Dose distributions were recalculated on CBCT images registered with the planning CT scanner. RESULTS:Compared with 7-field, step-and-shoot IMRT, VMAT plans resulted in improved planning target volume (PTV) D95% (7663.17 ± 69.57 cGy vs. 7789.17 ± 131.76 cGy, P < 0.001). VMAT reduced the rectal D25 (P < 0.001), D35 (P < 0.001), and D50 (P < 0.001), bladder V50 (P < 0.001), D25 (P = 0.002), D35 (P = 0.028), and D50 (P = 0.029). However, VMAT did not statistically significantly reduce the rectal V50, compared with 7-field, step-and-shoot IMRT (25.02 ± 5.54% vs. 27.43 ± 8.79%, P = 0.087). CONCLUSIONS:To deliver the hypofractionated radiotherapy in prostate cancer, VMAT significantly increased PTV D95% dose and decreased the dose of radiation delivered to adjacent normal tissues comparing to 7-field, step-and-shoot IMRT. Daily online image-guidance and better management of bladder and rectum could make a more precise treatment delivery.
journal_name
Chin Med J (Engl)journal_title
Chinese medical journalauthors
Li M,Li GF,Hou XY,Gao H,Xu YG,Zhao Tdoi
10.4103/0366-6999.183429subject
Has Abstractpub_date
2016-06-20 00:00:00pages
1447-54issue
12eissn
0366-6999issn
2542-5641pii
ChinMedJ_2016_129_12_1447_183429journal_volume
129pub_type
杂志文章abstract:BACKGROUND:Colon cancer is one of the major malignancies worldwide and it still remains resistant to much of the currently available chemotherapy. Downregulation of HGF/c-Met signaling pathway is an emerging therapy for cancer treatment. METHODS:In this study, the inhibitory effects of c-Met phosphorylation were obser...
journal_title:Chinese medical journal
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abstract:BACKGROUND:Alveolar echinococcosis (AE) is a disease in human and animals, and the cure rate is unsatisfactory. This study aimed to investigate the curative efficacy of different doses of locally applied radiotherapy on alveolar echinococcosis in rats. METHODS:Rats infected with Echinococcus multilocularis were random...
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doi:
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doi:
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doi:
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
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doi:
更新日期:2012-05-01 00:00:00
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doi:
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doi:
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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doi:
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doi:
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pub_type: 杂志文章
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doi:
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