Intensity Modulated Radiation Therapy Dose Painting for Localized Prostate Cancer Using 11C-choline Positron Emission Tomography Scans (original) (raw)

2012, International Journal of Radiation Oncology*Biology*Physics

After the embargo period  via non-commercial hosting platforms such as their institutional repository  via commercial sites with which Elsevier has an agreement In all cases accepted manuscripts should:  link to the formal publication via its DOI  bear a CC-BY-NC-ND licensethis is easy to do, click here to find out how  if aggregated with other manuscripts, for example in a repository or other site, be shared in alignment with our hosting policy  not be added to or enhanced in any way to appear more like, or to substitute for, the published journal article SUMMARY 11 C-choline PET scans can be used to identify foci of cancer within the prostate. A planning study on eight patients with localized prostate cancer compared the use of 11 C-choline PET-guided IMRT dose painting to 90 Gy with standard radiotherapy to 78 Gy in terms of technical feasibility and biological modeling. IMRT dose painting using 11 C-choline PET is technically feasible, results in higher tumor control probability, and does not raise the rectal normal tissue complication probability. Chang 5 ABSTRACT Purpose: To demonstrate the technical feasibility of IMRT dose painting using 11 Ccholine PET scans in patients with localized prostate cancer. Methods and materials: This was a radiotherapy planning study of eight patients with prostate cancer who had 11 C-choline PET scans prior to radical prostatectomy. Two contours were semi-automatically generated on the basis of the PET scans for each patient: 60% and 70% of the maximum standardized uptake values (SUV60% and SUV70%). Three IMRT plans were generated for each patient: PLAN78 which consisted of whole prostate radiotherapy to 78 Gy; PLAN78-90 which consisted of whole prostate radiotherapy to 78 Gy, a boost to the SUV60% to 84 Gy and a further boost to the SUV70% to 90 Gy; and PLAN72-90 which consisted of whole prostate radiotherapy to 72 Gy, a boost to the SUV60% to 84 Gy and a further boost to the SUV70% to 90 Gy. The feasibility of these plans was judged by their ability to reach prescription doses while adhering to published dose constraints. Tumor control probabilities based on PET scan-defined volumes (TCPPET) and on prostatectomydefined volumes (TCPpath), and rectal normal tissue complication probabilities (NTCP) were compared between the plans. Results: All plans for all patients reached prescription doses while adhering to dose constraints. The TCPPET values for PLAN78, PLAN78-90 and PLAN72-90 were 65%, 97% and 96%, respectively. The TCPpath values were 71%, 97% and 89%, respectively. Both PLAN78-90 and PLAN72-90 had significantly higher TCPPET (p = 0.002 and 0.001) and TCPpath (p < 0.001 and 0.014) than PLAN78. PLAN78-90 and Chang 6

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