Reduction of rectal dose by integration of the boost in the large-field treatment plan for prostate irradiation

被引:59
作者
Bos, LJ
Damen, EMF
de Boer, RW
Mijnheer, BJ
McShan, DL
Fraass, BA
Kessler, ML
Lebesque, JV
机构
[1] Netherlands Canc Inst, Div Radiotherapy, Antoni Van Leeuwenhoek Hosp, NL-1066 CX Amsterdam, Netherlands
[2] Univ Michigan, Med Ctr, Dept Radiat Oncol, Ann Arbor, MI 48109 USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2002年 / 52卷 / 01期
关键词
intensity-modulated radiotherapy (IMRT); prostate cancer; dose-escalation; treatment planning; dose-volume histogram;
D O I
10.1016/S0360-3016(01)02676-1
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To reduce the dose in the rectal wall from prostate irradiation at high dose levels. Methods and Materials: Treatment plans in which the boost fields were integrated into the large fields (simultaneous integrated boost [SIB]) were compared with plans in which the large fields and boost fields were planned individually and applied in a sequential manner (sequential boost). Two target volumes were delineated: PTV1, the target volume of the large fields that is irradiated to 68 Gy, and PTV2, the target volume of the boost fields that is irradiated to 10 Gy. The sequential boost and the SIB were normalized to the mean dose in PTV2, being 78 Gy. We used a five-field intensity-modulated radiotherapy (IMRT) technique, applied in a step and shoot mode, and included beam weight optimization. A set of 5 patients with varying degree of overlap between PTV1 and the rectal wall was used for analysis. Results: The SIB resulted in a reduction of the dose in the rectal wall. Rectal normal tissue complication probability (NTCP) decreased for the SIB, on average, by a factor of almost 2, compared with the sequential boost. Conclusion: The SIB reduced the dose in the rectal wall, compared with the sequential boost technique. (C) 2002 Elsevier Science Inc.
引用
收藏
页码:254 / 265
页数:12
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