Feasibility and Initial Dosimetric Findings for a Randomized Trial Using Dose-Painted Multiparametric Magnetic Resonance Imaging-Defined Targets in Prostate Cancer
Feasibility and Initial Dosimetric Findings for a Randomized Trial Using Dose-Painted Multiparametric Magnetic Resonance Imaging-Defined Targets in Prostate Cancer
复制标题
DOI：
10.1016/j.ijrobp.2016.01.052
复制
发表时间：
2016-06-01
影响因子：
7
通讯作者：
Pollack, Alan
中科院分区：
文献类型：
--
作者：
Bossart, Elizabeth L.;Stoyanova, Radka;Pollack, Alan
目的：比较 2 种治疗技术的剂量学特征与多参数磁共振成像识别的成像肿瘤体积（大体肿瘤体积，GTV）、前列腺临床靶体积和计划靶体积以及危险器官（OAR），这两种治疗技术代表大分割外束图像引导高度靶向放射治疗的机构 3 期随机试验的 2 个组。方法和材料：第 1 组（n = 20）患者在试验开始前接受标准剂量处方治疗。每个患者的实验组都会制定一个额外的治疗计划。总共比较了 40 个治疗计划（每种技术 20 个计划）。第 2 组 (n = 15) 由目前接受大分割外束图像引导高度靶向放射治疗试验的患者组成。根据治疗组制定计划，并为第 2 组实验组中的 5 个实验组制定额外计划，并在成像 GTV 中扩展 3 毫米。结果：对于两个患者组的所有计划，计划目标体积覆盖范围为 95% 至 100%；实验性治疗计划的 GTV 覆盖率为 89.3 Gy，覆盖范围为 95.2% 至 99.8%。对于第 1 组和第 2 组，实验计划中接受 40 Gy、65 Gy 和 80 Gy 照射的直肠/肛门和膀胱体积百分比均小于标准计划。对标准组和实验组之间的每分次 1 Gy 和每分次 1.625 Gy 的体积百分比进行了比较，结果发现这些百分比是相当的。结论：即使在同时向 GTV 提供较大的积分增强时，OAR 的每分次剂量也可以相等。数据表明，可以增加 GTV 裕度，而不会对 OAR 产生显着的剂量影响。 (C) 2016 Elsevier Inc. 保留所有权利。
Purpose: To compare dosimetric characteristics with multiparametric magnetic resonance imaging-identified imaging tumor volume (gross tumor volume, GTV), prostate clinical target volume and planning target volume, and organs at risk (OARs) for 2 treatment techniques representing 2 arms of an institutional phase 3 randomized trial of hypofractionated external beam image guided highly targeted radiation therapy.Methods and Materials: Group 1 (n = 20) patients were treated before the trial inception with the standard dose prescription. Each patient had an additional treatment plan generated per the experimental arm. A total of 40 treatment plans were compared (20 plans for each technique). Group 2 (n = 15) consists of patients currently accrued to the hypofractionated external beam image guided highly targeted radiation therapy trial. Plans were created as per the treatment arm, with additional plans for 5 of the group 2 experimental arm with a 3-mm expansion in the imaging GTV.Results: For all plans in both patient groups, planning target volume coverage ranged from 95% to 100%; GTV coverage of 89.3 Gy for the experimental treatment plans ranged from 95.2% to 99.8%. For both groups 1 and 2, the percent volumes of rectum/anus and bladder receiving 40 Gy, 65 Gy, and 80 Gy were smaller in the experimental plans than in the standard plans. The percent volume at 1 Gy per fraction and 1.625 Gy per fraction were compared between the standard and the experimental arms, and these were found to be equivalent.Conclusions: The dose per fraction to the OARs can be made equal even when giving a large simultaneous integrated boost to the GTV. The data suggest that a GTV margin may be added without significant dose effects on the OARs. (C) 2016 Elsevier Inc. All rights reserved.