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Retrospective dosimetric evaluation of VMAT plans for prostate cancer treatment

Published online by Cambridge University Press:  29 November 2018

Johnson Darko Open the ORCID record for Johnson Darko [Opens in a new window] ,
Ernest Osei ,
Andre Fleck  and
Ramana Rachakonda
Johnson Darko*
Affiliation:
Department of Medical Physics, Grand River Regional Cancer Centre, Kitchener, Ontario, Canada Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
Ernest Osei
Affiliation:
Department of Medical Physics, Grand River Regional Cancer Centre, Kitchener, Ontario, Canada Department of Physics and Astronomy, University of Waterloo, Waterloo, Ontario, Canada Department of Systems Design, University of Waterloo, Waterloo, Ontario, Canada Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
Andre Fleck
Affiliation:
Department of Medical Physics, Grand River Regional Cancer Centre, Kitchener, Ontario, Canada Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
Ramana Rachakonda
Affiliation:
Department of Radiation Oncology, Grand River Regional Cancer Centre, Kitchener, Ontario, Canada
*
Author for correspondence: Johnson Darko, Department of Medical Physics, Grand River Regional Cancer Centre, Kitchener, ON, Canada N2G 1G3. Tel: 519 749 4300/5793. E-mail: johnson.darko@grhosp.on.ca
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Abstract

Background

Radiation therapy (RT) remains a common and effective treatment modality for patients with locally advanced prostate cancer. Technological advancements over the past decade have resulted in the introduction of intensity-modulated radiation therapy (IMRT) planning and delivery techniques that maximise the dose of radiation delivered to the prostate while sparing organs at risk (OAR). A more recent and evolving IMRT technique, called volumetric-modulated arc therapy (VMAT), involves a continuous irradiation at a constant or variable dose rate when the gantry rotates around the prostate using one or more arcs.

Materials and methods

This paper reports on a dosimetric evaluation of our implementation of VMAT technique for prostate cancer treatment. A retrospective analysis of VMAT plans was performed for 300 prostate cancer patients treated during the period of January 2013 to December 2014. Two prescription cohorts of patients treated to a dose of 78 Gy in 39 fractions as the primary radiation therapy treatment (XRT) and 66 Gy in 33 fractions as a post-op or salvage XRT were considered.

Results

The mean and maximal doses, dose inhomogeneities and conformity indexes for the planning target volumes were evaluated for each prescription cohort of patients. Similarly, the doses to OAR such as rectum, bladder and femoral heads were also assessed for various dose levels.

Conclusion

This study shows that highly conformal radiation dose distribution for the treatment of prostate cancer is achievable with the VMAT technique. It provides evidence to support the adoption of such conformal technology in many disease sites such as the prostate. We believe that our experience reported here could help form the foundation for individual institutions to evaluate and develop the most suitable planning criteria tailored to their own needs and priority. This endeavour hopefully will provide further improvement in the planning process and, therefore, help achieve an effective and efficient delivery of radiotherapy for prostate cancer.

Keywords

dosimetryprostate cancerradiotherapyRapidArcvolumetric-modulated arc therapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 2 , June 2019 , pp. 155 - 164
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Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Darko J, Osei E, Fleck A, Rachakonda R (2019) Retrospective dosimetric evaluation of VMAT plans for prostate cancer treatment. Journal of Radiotherapy in Practice18: 155–164. doi: 10.1017/S1460396918000596

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