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Comparison of three radiotherapy treatment planning protocols of definitive external-beam radiation for localized prostate cancer

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Abstract

Background

Three radiotherapy treatment planning (RTTP) protocols for definitive external-beam radiation for localized prostate cancer, designed and clinically applied at Kyoto University, were compared.

Methods

Treatment plans were created according to three different RTTP protocols (old three-dimensional conformal radiotherapy [3D-CRT], new 3D-CRT, and intensity-modulated radiotherapy [IMRT]) on computed tomography (CT) data sets of five patients with localized prostate cancer. The dynamic-arc conformal technique was used in the 3D-CRT protocols. Differences in dose distribution were evaluated and compared based on dose-volume histogram (DVH) analyses.

Results

The coverage of the clinical target volume (= prostate alone) was comparable among the three RTTP protocols. However, the average values for the percent volume that received at least 95% of the prescription dose (V95), the percent of the prescription dose covering 95% of the volume (D95), and the conformity index of the planning target volume (PTV) were 99%, 97%, and 0.88 for the IMRT; 93.9%, 94.5%, and 0.76 for the new 3D-CRT; and 59.6%, 82.9%, and 0.6 for the old 3D-CRT protocol, respectively. Inhomogeneity of doses to the PTV was larger with the IMRT protocol than with the new 3D-CRT protocol. Doses to both the rectal wall and bladder wall were almost comparable with the new 3D-CRT and IMRT protocols, but were lower with the old 3D-CRT protocol, due to the lowest prescription dose and incomplete dose coverage of the PTV.

Conclusion

The old 3D-CRT protocol could not achieve the goals for the PTV set in the IMRT protocol. The new 3D-CRT and IMRT protocols were generally comparable in terms of both the PTV coverage and normal tissue-sparing, although the IMRT protocol achieved the most conformal dose distribution to the PTV, in return for a larger, but acceptable, dose inhomogeneity.

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Authors and Affiliations

  1. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    SuYu Zhu, Takashi Mizowaki, Yasushi Nagata, Kenji Takayama, Yoshiki Norihisa, Shinsuke Yano & Masahiro Hiraoka

Authors
  1. SuYu Zhu
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  2. Takashi Mizowaki
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  3. Yasushi Nagata
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  4. Kenji Takayama
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  5. Yoshiki Norihisa
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  6. Shinsuke Yano
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  7. Masahiro Hiraoka
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Corresponding author

Correspondence to Takashi Mizowaki.

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Zhu, S., Mizowaki, T., Nagata, Y. et al. Comparison of three radiotherapy treatment planning protocols of definitive external-beam radiation for localized prostate cancer. Int J Clin Oncol 10, 398–404 (2005). https://doi.org/10.1007/s10147-005-0519-4

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  • DOI: https://doi.org/10.1007/s10147-005-0519-4

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