Open AccessHybrid Tomo‐Helical and Tomo‐Direct radiotherapy for localized prostate cancer
Author(s) -
Karaca Sibel,
Koca Timur,
Sarpün İsmail Hakkı,
Tunçel Nina,
Korcum Şahin Aylin Fidan
Publication year - 2021
Publication title -
journal of applied clinical medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.83
H-Index - 48
ISSN - 1526-9914
DOI - 10.1002/acm2.13406
Subject(s) - medicine , nuclear medicine , radiation treatment planning , wilcoxon signed rank test , rectum , radiation therapy , prostate cancer , prostate , cancer , surgery , mann–whitney u test
Purpose The aim of the study is to present a new planning approach to provide better planning target volume (PTV) coverage and reduce bladder and rectum dose with hybrid Tomo‐Helical (TH)/Tomo‐Direct (TD) radiotherapy (RT) for localized prostate cancer (LPC). Methods Twenty‐five LPC patients were included in this retrospective study. TH plans, TD plans, and hybrid TH/TD plans were created. Lateral beams were used for the hybrid TD plan and the prescribed dose was 70 Gy in 28 fractions (hybrid plans were combined 45 Gy/ 18 fxs for TH and 25 Gy/10 fxs for TD). Doses of PTV (D2%, D98%, D50%, homogeneity index (HI), conformity index (CI), coverage) and organs at risk (OARs) (V50%, V35%, V25%, V5%, and V95%) were analyzed. The Wilcoxon signed‐rank test was used to analyze the difference in dosimetric parameters. p‐ Value < 0.05 was considered statistically significant. Results TH plans showed better CI, and target coverage ( p < 0.01) than TD and hybrid plans in all patient plan evaluations. However, TD plans D2%, D98%, and D50% doses were better than TH and hybrid plans. The HI values were similar between the three plans. Significant reductions in bladder and rectum V50%, V35%, and V25% doses ( p < 0.001) were observed with hybrid plans compared to TH and TD. Penile bulb V95% and bowel V5% doses were better in the hybrid plans. Left and right femoral head V5% doses were higher in the hybrid plan compared to others ( p < 0.001). Conclusion Concurrently hybrid TH/TD RT plan can be a good option to reduce the doses of the rectum and bladder in the RT of LPC.