scholarly journals Dosimetric and biological comparison of treatment plans between EDGE and CyberKnife systems in stereotactic body radiation therapy for localized prostate cancer

2020 ◽  
Author(s):  
Zhitao Dai ◽  
Lian Zhu ◽  
Tingting Cao ◽  
Aihua Wang ◽  
Xueling Guo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Normal Tissue ◽  
Stereotactic Body Radiation Therapy ◽  
Localized Prostate Cancer ◽  
Conformity Index ◽  
Delivery Time ◽  
Plan Quality ◽  
Dose Volume ◽  
Treatment Plans

Abstract Aims: The aim of this study was to make a quantitative comparison of plan quality between MLC-based EDGE system and the cone-based CyberKnife system in stereotactic body radiation therapy (SBRT) for patients with localized prostate cancer.Materials and methods: Ten patients with prostate volumes ranging from 34.65 to 82.16 cc were used for prostate SBRT. Treatment plans were created for both EDGE and CyberKnife G4 systems using the same dose-volume constraints. Dosimetric indices including Planning Tumor Volume (PTV) coverage, conformity index (CI), new conformity index (nCI), homogeneity index (HI), gradient index (GI) were applied for target, while the sparing of critical organs, including bladder, rectum, femoral heads, urethra, penile bulk and normal tissue outside PTV), were evaluated interms of various dose-volume metrics and integral dose (ID). Meanwhile, the required delivery time and number of monitor units (MUs) during irradiation were measured to estimate the treatment efficiency. The radiobiological indices such as equivalent uniform dose (EUD), tumor control probability (TCP) and the normal tissue complication probability (NTCP) were also analyzed. Results: All dose constraints were achieved by both systems. It showed that the DEGE plans results were closest to the CK plans results in terms of PTV coverage, HI and GI. For EDGE, more conformal dose distribution in the target as well as reduced exposure of critical organs were obtained together with reduction of 91% delivery time and 72% monitor units. EDGE plans also got lower EUD for bladder, rectum, urethra and penile bulk, which associated with reduction of NTCPs. However, higher values of EUD and TCP for tumor were obtained with CK plans. Conclusions: Our study indicated that both systems were capable of producing almost equivalent plan quality and can meet clinical requirements. CyberKnife G4 system has higher target dose while EDGE system has more advantages based on the considerations of normal tissue sparing and delivery efficiency. With abundant clinical experience, CK provides accurate SBRT treatment with high quality. EDGE system also can be considered to be an option for SBRT treatment for localized prostate cancer treatment.

Dosimetric and biological comparison of treatment plans between LINAC and robot  systems in stereotactic body radiation therapy for localized prostate cancer

2021 ◽  
Author(s):  
Zhitao Dai ◽  
Lian Zhu ◽  
Tingting Cao ◽  
Aihua Wang ◽  
Xueling Guo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Normal Tissue ◽  
Stereotactic Body Radiation Therapy ◽  
Localized Prostate Cancer ◽  
Conformity Index ◽  
Delivery Time ◽  
Plan Quality ◽  
Dose Volume ◽  
Treatment Plans

Abstract Aims The aim of this study was to make a quantitative comparison of plan quality between MLC-based EDGE system and the cone-based CyberKnife system in stereotactic body radiation therapy (SBRT) for patients with localized prostate cancer. Materials and methods Ten patients with prostate volumes ranging from 34.65 to 82.16 cc were used for prostate SBRT. Treatment plans were created for both EDGE and CyberKnife G4 systems using the same dose-volume constraints. Dosimetric indices including Planning Tumor Volume (PTV) coverage, conformity index (CI), new conformity index (nCI), homogeneity index (HI), gradient index (GI) were applied for target, while the sparing of critical organs, including bladder, rectum, femoral heads, urethra, penile bulk and normal tissue outside PTV), were evaluated interms of various dose-volume metrics and integral dose (ID). Meanwhile, the required delivery time and number of monitor units (MUs) during irradiation were measured to estimate the treatment efficiency. The radiobiological indices such as equivalent uniform dose (EUD), tumor control probability (TCP) and the normal tissue complication probability (NTCP) were also analyzed. Results All dose constraints were achieved by both systems. It showed that the DEGE plans results were closest to the CK plans results in terms of PTV coverage, HI and GI. For EDGE, more conformal dose distribution in the target as well as reduced exposure of critical organs were obtained together with reduction of 91% delivery time and 72% monitor units. EDGE plans also got lower EUD for bladder, rectum, urethra and penile bulk, which associated with reduction of NTCPs. However, higher values of EUD and TCP for tumor were obtained with CK plans. Conclusions Our study indicated that both systems were capable of producing almost equivalent plan quality and can meet clinical requirements. CyberKnife G4 system has higher target dose while EDGE system has more advantages based on the considerations of normal tissue sparing and delivery efficiency. With abundant clinical experience, CK provides accurate SBRT treatment with high quality. EDGE system also can be considered to be an option for SBRT treatment for localized prostate cancer treatment.

scholarly journals SpaceOAR hydrogel spacer injection prior to stereotactic body radiation therapy for men with localized prostate cancer

Medicine ◽  
2021 ◽  
Vol 100 (49) ◽  
pp. e28111
Author(s):  
Heather A. Payne ◽  
Michael Pinkawa ◽  
Clive Peedell ◽  
Samir K. Bhattacharyya ◽  
Emily Woodward ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Localized Prostate Cancer ◽  
Stereotactic Body Radiation ◽  
Spaceoar Hydrogel

Dosimetric evaluation of whole-pelvis radiation therapy of prostate cancers: clinical experience

2020 ◽  
pp. 1-15
Author(s):  
Ernest Osei ◽  
Hafsa Mansoor ◽  
Johnson Darko ◽  
Beverley Osei ◽  
Katrina Fleming ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Cancer Patients ◽  
Seminal Vesicles ◽  
Conformity Index ◽  
Prostate Bed ◽  
Risk Patients ◽  
Treatment Plans ◽  
The Mean

Abstract Background: The standard treatment modalities for prostate cancer include surgery, chemotherapy, hormonal therapy and radiation therapy or any combination depending on the stage of the tumour. Radiation therapy is a common and effective treatment modality for low-intermediate-risk patients with localised prostate cancer, to treat the intact prostate and seminal vesicles or prostate bed post prostatectomy. However, for high-risk patients with lymph node involvement, treatment with radiation will usually include treatment of the whole pelvis to cover the prostate and seminal vesicles or prostate bed and the pelvic lymph nodes followed by a boost delivery dose to the prostate and seminal vesicles or prostate bed. Materials and Methods: We retrospectively analysed the treatment plans for 179 prostate cancer patients treated at the cancer centre with the volumetric-modulated arc therapy (VMAT) technique via RapidArc using 6 MV photon beam. Patients were either treated with a total prescription dose of 78 Gy in 39 fractions for patients with intact prostate or 66 Gy in 33 fractions for post prostatectomy patients. Results: There were 114 (64%) patients treated with 78 Gy/39 and 65 (36%) treated with 66 Gy/34. The mean homogeneity index (HI), conformity index (CI) and uniformity index (UI) for the PTV-primary of patients treated with 78 Gy are 0.06 ± 0.01, 1.04 ± 0.01 and 0.99 ± 0.01, respectively, and the corresponding mean values for patients treated with 66 Gy are 0.06 ± 0.02, 1.05 ± 0.01 and 0.99 ± 0.01, respectively. The mean PTV-primary V95%, V100% and V105% are 99.5 ± 0.5%, 78.8 ± 12.2% and 0.1 ± 0.5%, respectively, for patients treated with 78 Gy and 99.3 ± 0.9%, 78.1 ± 10.6% and 0.1 ± 0.4%, respectively, for patients treated with 66 Gy. The rectal V50Gy, V65Gy, V66.6Gy, V70Gy, V75Gy and V80Gy are 26.8 ± 9.1%, 14.2 ± 5.3%, 13.1 ± 5.0%, 10.8 ± 4.3%, 6.9 ± 3.1% and 0.1 ± 0.1%, respectively, for patients treated with 78 Gy and 33.7 ± 8.4%, 14.1 ± 4.5%, 6.7 ± 4.5%, 0.0 ± 0.2%, 0.0% and 0.0%, respectively, for patients treated with 66 Gy. Conclusion: The use of VMAT technique for radiation therapy of high-risk prostate cancer patients is an efficient and reliable method for achieving superior dose conformity, uniformity and homogeneity to the PTV and minimal doses to the organs at risk. Results from this study provide the basis for the development and implementation of consistent treatment criteria in radiotherapy programs, have the potential to establish an evaluation process to define a consistent, standardised and transparent treatment path for all patients that reduces significant variations in the acceptability of treatment plans and potentially improve patient standard of care.

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