Treatment Plan Comparison between IMRT and Volumetric IMAT using One- and Two-arc Beams for Prostate Cancer

Author(s):  
S. Yoo ◽  
J. Wu ◽  
W.R. Lee ◽  
F. Yin
Author(s):  
Ornela Bardhi ◽  
Begonya Garcia-Zapirain ◽  
Roberto Nuño-Solinis

Breast cancer (BCa) and prostate cancer (PCa) are the most prevalent types of cancers. We aimed to understand and analyze the care pathways for BCa and PCa patients followed at a hospital setting by analyzing their different treatment lines. We evaluated the association between different treatment lines and the lifestyle and demographic characteristics of these patients. Two datasets were created using the electronic health records (EHRs) and information collected through semi-structured one-on-one interviews. Statistical analysis was performed to examine which variable had an impact on the treatment each patient followed. In total, 83 patients participated in the study that ran between January and November 2018 in Beacon Hospital. Results show that chemotherapy cycles indicate if a patient would have other treatments, i.e., patients who have targeted therapy (25/46) have more chemotherapy cycles (95% CI 4.66–9.52, p = 0.012), the same is observed with endocrine therapy (95% CI 4.77–13.59, p = 0.044). Patients who had bisphosphonate (11/46), an indication of bone metastasis, had more chemotherapy cycles (95% CI 5.19–6.60, p = 0.012). PCa patients with tall height (95% CI 176.70–183.85, p = 0.005), heavier (95% CI 85.80–99.57, p < 0.001), and a BMI above 25 (95% CI 1.85–2.62, p = 0.017) had chemotherapy compared to patients who were shorter, lighter and with BMI less than 25. Initial prostate-specific antigen level (PSA level) indicated if a patient would be treated with bisphosphonate or not (95% CI 45.51–96.14, p = 0.002). Lifestyle variables such as diet (95% CI 1.46–1.85, p = 0.016), and exercise (95% CI 1.20–1.96, p = 0.029) indicated that healthier and active BCa patients had undergone surgeries. Our findings show that chemotherapy cycles and lifestyle for BCa, and tallness and weight for PCa may indicate the rest of treatment plan for these patients. Understanding factors that influence care pathways allow a more person-centered care approach and the redesign of care processes.


Author(s):  
Christopher L. Lee ◽  
Max C. Dietrich ◽  
Uma G. Desai ◽  
Ankur Das ◽  
Suhong Yu ◽  
...  

This paper presents the design evolution, fabrication, and testing of a novel patient and organ-specific, three-dimensional (3D)-printed phantom for external beam radiation therapy (EBRT) of prostate cancer. In contrast to those found in current practice, this phantom can be used to plan and validate treatment tailored to an individual patient. It contains a model of the prostate gland with a dominant intraprostatic lesion (DIL), seminal vesicles, urethra, ejaculatory duct, neurovascular bundles, rectal wall, and penile bulb generated from a series of combined T2-weighted/dynamic contrast-enhanced magnetic resonance (MR) images. The iterative process for designing the phantom based on user interaction and evaluation is described. Using the CyberKnife System at Boston Medical Center, a treatment plan was successfully created and delivered. Dosage delivery results were validated through gamma index calculations based on radiochromic film measurements which yielded a 99.8% passing rate. This phantom is a demonstration of a methodology for incorporating high-contrast MR imaging into computed-tomography-based radiotherapy treatment planning; moreover, it can be used to perform quality assurance (QA).


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