A dosimetric selectivity intercomparison of HDR brachytherapy, IMRT and helical tomotherapy in prostate cancer radiotherapy.

Hermesse, Johanne;Biver, Sylvie;Jansen, Nicolas;Lenaerts, Eric;Nickers, Philippe;et.al.
(2009) Strahlentherapie und Onkologie : Zeitschrift für Radiologie, Strahlenbiologie, Strahlenphysik — Vol. 185, n° 11, p. 736-742 (2009)

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Authors
  • Hermesse, Johanne
    Author
  • Biver, Sylvie
    Author
  • Jansen, Nicolas
    Author
  • Lenaerts, Eric
    Author
  • De Patoul, NathalieUCLouvain
    Author
  • Vynckier, StefaanUCLouvain
    Author
  • Scalliet, PierreUCLouvain
    Author
  • Nickers, Philippe
    Author
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Abstract
BACKGROUND AND PURPOSE: Dose escalation in order to improve the biochemical control in prostate cancer requires the application of irradiation techniques with high conformality. The dosimetric selectivity of three radiation modalities is compared: high-dose-rate brachytherapy (HDR-BT), intensity-modulated radiation radiotherapy (IMRT), and helical tomotherapy (HT). PATIENTS AND METHODS: Ten patients with prostate adenocarcinoma treated by a 10-Gy HDR-BT boost after external-beam radiotherapy were investigated. For each patient, HDR-BT, IMRT and HT theoretical treatment plans were realized using common contour sets. A 10-Gy dose was prescribed to the planning target volume (PTV). The PTVs and critical organs' dose-volume histograms obtained were compared using Student's t-test. RESULTS: HDR-BT delivers spontaneously higher mean doses to the PTV with smaller cold spots compared to IMRT and HT. 33% of the rectal volume received a mean HDR-BT dose of 3.86 + or - 0.3 Gy in comparison with a mean IMRT dose of 6.57 + or - 0.68 Gy and a mean HT dose of 5.58 + or - 0.71 Gy (p < 0.0001). HDR-BT also enables to better spare the bladder. The hot spots inside the urethra are greater with HDR-BT. The volume of healthy tissue receiving 10% of the prescribed dose is reduced at least by a factor of 8 with HDR-BT (p < 0.0001). CONCLUSION: HDR-BT offers better conformality in comparison with HT and IMRT and reduces the volume of healthy tissue receiving a low dose.
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Hermesse, J., Biver, S., Jansen, N., Lenaerts, E., De Patoul, N., Vynckier, S., Coucke, P., Scalliet, P., & Nickers, P. (2009). A dosimetric selectivity intercomparison of HDR brachytherapy, IMRT and helical tomotherapy in prostate cancer radiotherapy. Strahlentherapie und Onkologie : Zeitschrift für Radiologie, Strahlenbiologie, Strahlenphysik, 185(11), 736-742. https://doi.org/10.1007/s00066-009-2009-5 (Original work published 2009)