Dosimetric Evaluation of Intensity Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy Treatment Plans for Prostate Cancer
Dosimetric Evaluation of Intensity Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy Treatment Plans for Prostate Cancer
OBJECTIVE We evaluated the homogeneity index and conformity index using intensity modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) treatment plans in prostate cancer. METHODS Twenty treatment plans for ten patients were created using 3D-CRT of four-fields with gantry angles of 0⁰, 90⁰, 180⁰, and 270⁰; and IMRT of five-fields with gantry angles of 0⁰, 72⁰, 144⁰, 216⁰, and 288⁰ on an Eclipse Treatment Planning System (version 15.6). The volume of reference isodose, target volume, maximum isodose in the target, reference isodose, dose at 95% of planning target volume (PTV), dose at 2%, 5%, and 98% of PTV, and prescribed dose were collected from the dose volume histogram of each plan. The conformity index and homogeneity index (HI) were then calculated. The doses of the organs at risk were also collected and evaluated. RESULTS The HI of the twenty patients who underwent the treatment plan with 3D-CRT was 1.088±0.03, which shows good homogeneity, but less homogeneity when compared with plans done with IMRT (1.072±0.02). CONCLUSION The use of IMRT treatment plan for prostate cancer proved to be superior over 3D-CRT in terms of conformity and homogeneity, as well as sparring dose to organ at risk.
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- 1. American Cancer Society: available at: https://www. cancer.org/research/cancer-facts-statistics/all-cancerfacts-figures/cancer-facts-figures-2019.html. Accessed Jun 8, 2020.
- 2. The International Agency for Research on Cancer: The Global Cancer Observatory. 2019. Available at: https:// gco.iarc.fr/. Accessed Jun 8, 2020.
- 3. Nigeria Health Blog. Available at: https://nimedhealth. com.ng/2019/02/05/prostate-cancer-in-nigeria-epimiology-awareness-screening-symptoms-treatment. Accessed Jun 8, 2020.
- 4. Hou H, Swanson D, Barqawi AB. Modalities for Imaging Prostate Cancer. Hindawi Publishing Corporation Advances in Urology 2009;65:12.
- 5. Quantitative Analysis of Normal Tissue Effects in Clinic (QUANTEC). International Journal of Radiation Oncology, Biology and Physics 2010;76(Suppl):S3−S9.
- 6. ICRU. Prescribing, Recording, and Reporting Intensity-Modulated Photon-Beam Therapy (IMRT)(ICRU Report 83). Journal of International Commission on Radiation Units and Measurements 2010;10:1−106.
- 7. Viswanathan AN, Yorke ED, Marks LB. Radiation dose-volume effects of the urinary bladder. International Journal of Radiation Oncology, Biology and Physics 2010;76(Suppl. 3):S116–22
- 8. Michalski JM, Gay H, Jackson A, Tucker SL, Deasy JO. Radiation dose-volume effects in radiation-induced rectal injury. International Journal of Radiation Oncology, Biology and Physics. 2010;76(3 Suppl):S123–9.
- 9. Eifel PJ, Winter K, Morris M, Levenback C, Grigsby PW, Cooper J, et al. Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aortic irradiation for high-risk cervical cancer: an update of radiation therapy oncology group trial (RTOG) 90-01. J Clin Oncol 2004;22(5):872−80.
- 10.Knoos T, Kristensen I, Nilsson P. Volumetric and dosimetric evaluation of radiation treatment plans: radiation conformity index. Journal of Radiation Oncology, Biology, Physics 1998;42(5):1169−76.
- 11.Yoon M, Park SY, Shin D, Lee SB, Pyo HR, Kim DY. A new homogeneity index based on statistical analysis of the dose-volume histogram; Journal of Applied Clinical Medical Physics 2007;8(2):9−17.
- 12.Wu VW, Kwong DL, Sham JS. Target dose conformity in 3-dimensional conformal radiotherapy and intensity modulated radiotherapy. Radiotherapy Oncology 2004:71(2):201−6.
- 13.Crowe SB, Kairn T, Middlebrook N, Hill B, Christie DR, Knight RT, et al. Retrospective evaluation of dosimetric quality for prostate carcinomas treated with 3D conformal, intensity modulated and volumetric modulated arc radiotherapy. J Med Radiat Sci 2013;60(4):131−8.
- 14.Cristofaro N, Hindson B, Sanderson C. Retropective dosimetric comparison of three-dimensional conformal radiotherapy (3D-CRT), sliding window intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) for protate cancer. 2014, R-0144. Available at: https://epos.myesr.org/poster/ ranzcr/ranzcr2014/R-0144. Accessed Jun 8, 2020.
- 15.AL-Shareef JM, Attalla EM, Khalil MM, Abdelaal AM, El-Nagdy MS. A comparison of intensity modulated and 3-Dimensional conformal radiotherapy for prostate cancer using 6-MV and 15-MV photon energies. Arab Journal of Nuclear Science and Applications. 2020;53(2):189−200.
- 16.Kinhikar RA, Pawar AB, Mahantshetty U, Murthy V, Dhehpande DD, Shrivastava SK. Rapid Arc, helical tomotherapy, sliding window intensity modulated radiotherapy and three dimensional conformal radiation for localized prostate cancer: A dosimetric com- parison. Journal of Cancer Resaerch and Therapeutics 2014;10(3):575−82.
- 17.Uysal B, Beyzadeoglu M, Sager O, Dincoglan F, Demiral S, Gamsiz H, et al. Dosimetric evaluation of intensity modulated radiotherapy and 4-Field 3D-confromal radiotherapy in prostate cancer. Balkan Medical Journal 2013;30:54−7.
- 18.Ashman JB, Zelefsky MJ, Hunt MS, Leibel SA, Fuks Z. Whole pelvic radiotherapy for prostate cancer using 3D conformal and intensity-modulated radiotherapy; International Journal of Radiation Oncology Biology Physics 2005;63(3):765−71.
- 19.Wortel R, Incrocci L, Pos F, Van Der Heide U, Lebesque J, Aluwini S, et al. PO-0742: Image-guided IMRT reduces late toxicity compared to 3D-CRT for prostate cancer. Radiotherapy and Oncology 2016;119(Supplement 1):S346−S7.
- 20.Mavroidis P, Komisopoulos G, Buckey C, Mavroeidi M, Swanson GP, Baltas D, et al. Radiobiological evaluation of prostate cancer IMRT and conformal-RT plans using different treatment protocols. Phys Med 2017;40:33−41.