Dosimetric Parameters Comparison of Four-Field and Field-in-Field Radiotherapy Planning in Treatment of Prostate Cancer
Abstract
Purpose: Prostate cancer is one of the most common malignant cancers. Several radiotherapy planning methods have been suggested for the treatment of prostate cancer. In this study, four-field, and Field-In-Field (FIF) planning methods were compared based on dosimetric parameters.
Materials and Methods: In the radiotherapy Treatment Planning System (TPS) for 10 patients who were treated with the common four-field method, the planning was also performed by the FIF method. Dosimetric parameters were measured for Planning Target Volume (PTV), rectum, and bladder. These parameters included maximum dose, minimum dose, mean dose, V15%, V25%, V30%, and V35%, as well as Homogeneity Index (HI) and Conformity Index (CI). Two treatment planning methods based on dosimetric parameters were compared using paired t-test.
Results: Maximum, minimum and mean dose in PTV, rectum, and bladder were significantly different for the two techniques. There was no significant difference between the two planning techniques in dosimetric parameters of V15%, V25%, V30%, and V35% for rectum and bladder. The FIF technique delivers more doses to the tumor. HI was better in the FIF method than in the four-field method, but CI was not significantly different. In both techniques, the rectum and bladder did not receive doses above 60 Gy.
Conclusion: In the treatment of prostate cancer in both Four-field and FIF planning methods, the dose to the rectum and bladder is less than the tolerance dose. FIF technique is recommended to better control the tumor. Based on dosimetric parameters, no significant findings were obtained that prove the superiority of FIF over the four-field technique in the treatment of prostate cancer.
2- Beatriz Sánchez-Nieto et al., "External photon radiation treatment for prostate cancer: Uncomplicated and cancer free control probability assessment of 36 plans." Physica Medica, Vol. 66pp. 88-96, (2019). 3- Hossein Rafimanesh, Mahshid Ghoncheh, Hamid Salehinia, and Abdollah Mohammadian Hafashjani, "Epidemiology of prostate cancer and its incidence trends in Iran." Journal of Sabzevar University of Medical Sciences, Vol. 23 (No. 2), pp. 320-27, (2016).
4- Faiz M Khan, Paul W Sperduto, and John P Gibbons, Khan's Treatment Planning in Radiation Oncology. Lippincott Williams & Wilkins, (2021).
5- Edward C Halperin, Luther W Brady, David E Wazer, and Carlos A Perez, Perez & Brady's principles and practice of radiation oncology. Lippincott Williams & Wilkins, (2013).
6- Linda W Chan et al., "Proposed rectal dose constraints for patients undergoing definitive whole pelvic radiotherapy for clinically localized prostate cancer." International Journal of Radiation Oncology* Biology* Physics, Vol. 72 (No. 1), pp. 69-77, (2008).
7- P Milecki, T Piotrowski, and M Dymnicka, "The comparison of radiotherapy techniques for treatment of the prostate cancer: the three-field vs. the four-field." Neoplasma, Vol. 51 (No. 1), pp. 64-69, (2004). 8- Bahman Emami et al., "Tolerance of normal tissue to therapeutic irradiation." International Journal of Radiation Oncology* Biology* Physics, Vol. 21 (No. 1), pp. 109-22, (1991).
9- Martin Hauer-Jensen, Junru Wang, and James W Denham, "Bowel injury: current and evolving management strategies." in Seminars in radiation oncology, (2003), Vol. 13 (No. 3): Elsevier, pp. 358-71. 10- PS Hasleton, N Carr, and PF Schofield, "Vascular changes in radiation bowel disease." Histopathology, Vol. 9 (No. 5), pp. 517-34, (1985).
11- Luis Felipe Fajardo, "The pathology of ionizing radiation as defined by morphologic patterns." Acta oncologica, Vol. 44 (No. 1), pp. 13-22, (2005).
12- Nicholas A Serrano, Noah S Kalman, and Mitchell S Anscher, "Reducing rectal injury in men receiving prostate cancer radiation therapy: current perspectives." Cancer management and research, Vol. 9pp. 339-50, (2017).
13- R Prabhakar, PK Julka, and GK Rath, "Can field-in-field technique replace wedge filter in radiotherapy treatment planning: a comparative analysis in various treatment sites." Australasian Physics & Engineering Sciences in Medicine, Vol. 31 (No. 4), pp. 317-24, (2008).
14- EK Osei, R Jiang, R Barnett, K Fleming, and D Panjwani, "Evaluation of daily online set-up errors and organ displacement uncertainty during conformal radiation treatment of the prostate." The British journal of radiology, Vol. 82 (No. 973), pp. 49-61, (2009).
15- Jackson Wu et al., "Positioning errors and prostate motion during conformal prostate radiotherapy using on-line isocentre set-up verification and implanted prostate markers." Radiotherapy and Oncology, Vol. 61 (No. 2), pp. 127-33, (2001).
16- Bo Sterckx, Isabell Steinseifer, and Markus Wendling, "In vivo dosimetry with an electronic portal imaging device for prostate cancer radiotherapy with an endorectal balloon." Physics and Imaging in Radiation Oncology, Vol. 12pp. 7-9, (2019).
17- Felix Böckelmann, Florian Putz, Karoline Kallis, Sebastian Lettmaier, Rainer Fietkau, and Christoph Bert, "Adaptive radiotherapy and the dosimetric impact of inter-and intrafractional motion on the planning target volume for prostate cancer patients." Strahlentherapie und Onkologie, Vol. 196 (No. 7), pp. 647-56, (2020).
18- Katharina Bell, Yvonne Dzierma, Melanie Morlo, Frank Nüsken, Norbert Licht, and Christian Rübe, "Image guidance in clinical practice–Influence of positioning inaccuracy on the dose distribution for prostate cancer." Physica Medica, Vol. 46pp. 81-88, (2018).
19- Tingting Cao, Zhitao Dai, Zhen Ding, Wuzhou Li, and Hong Quan, "Analysis of different evaluation indexes for prostate stereotactic body radiation therapy plans: conformity index, homogeneity index and gradient index." Precision Radiation Oncology, Vol. 3 (No. 3), pp. 72-79, (2019).
20- Ian Paddick, "A simple scoring ratio to index the conformity of radiosurgical treatment plans." Journal of neurosurgery, Vol. 93 (No. supplement_3), pp. 219-22, (2000).
21- MI El Gohary, EM Attalla, and IM Hassan, "Evaluation of 3D Conformal Radiotherapy for Prostate Cancer Using Dosimetric Indices." Egyptian Journal of Biomedical Engineering and Biophysics, Vol. 17 (No. 1), pp. 53-65, (2016).
22- Guler Yavas et al., "Dosimetric comparison of 3- dimensional conformal and field-in-field radiotherapy techniques for the adjuvant treatment of early stage endometrial cancer." Physica Medica, Vol. 29 (No. 6), pp. 577-82, (2013).
23- Michael J Zelefsky et al., "Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer." International Journal of Radiation Oncology* Biology* Physics, Vol. 70 (No. 4), pp. 1124-29, (2008).
24- Bahman Emami, "Tolerance of normal tissue to therapeutic radiation." Reports of radiotherapy and Oncology, Vol. 1 (No. 1), pp. 123-7, (2013).
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Issue | Vol 9 No 4 (2022) | |
Section | Technical Note | |
DOI | https://doi.org/10.18502/fbt.v9i4.10427 | |
Keywords | ||
Field In Field Radiotherapy Prostate Cancer Treatment Planning Dosimetry Parameters |
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