Dosimetric feasibility of stereotactic irradiation of primary prostate cancer at 5x9 Gy with a method of urethral sparing
The most commonly used dose for prostate cancer stereotactic body radiotherapy (SBRT) is 5 × 7.25 Gy. The aim of this study was to evaluate the dosimetric feasibility of a 5 × 9 Gy SBRT regimen while still limiting the dose to the urethra to 5 × 7.25 Gy. This dosimetric study is part of the groundwo...
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| Veröffentlicht in: | British journal of radiology 2021-11, Vol.94 (1127), p.20210142-20210142 |
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| creator | Benhmida, Salim Beneux, Amandine Udrescu, Corina Rouviere, Olivier Horn, Samy Enachescu, Ciprian Lapierre, Ariane Chapet, Olivier |
| description | The most commonly used dose for prostate cancer stereotactic body radiotherapy (SBRT) is 5 × 7.25 Gy. The aim of this study was to evaluate the dosimetric feasibility of a 5 × 9 Gy SBRT regimen while still limiting the dose to the urethra to 5 × 7.25 Gy. This dosimetric study is part of the groundwork for a future Phase III randomized trial.
The prostate, the urethra and the tumors were delineated on 20 dosimetric CT-scans with MRI-registration. The planning target volume (PTVp) was defined as a 5 mm expansion (3 mm posteriorly) of the prostate. The planning at risk volume (PRVu) was defined as a 2 mm expansion of the urethra. The tumors were delineated on the MRI (GTVt) and a 3 mm-margin was added to create a tumoral planning target volume (PTVt). IMRT plans were optimized to deliver 5 × 9 Gy to the PTVp, limiting the dose to the PRVu to 5 × 7.25 Gy. Results are presented using average (range) values.
PTVp doses were D98% = 36.2 Gy (35.6-36.8), D2% = 46.9 Gy (46.5-47.5) and mean dose = 44.1 Gy (43.8-44.5). The dose to the PRVu was within tolerance limits for all 20 patients: V34.4Gy = 99.8% (99.2-100) and D5% = 38.7 Gy (38.6-38.8). Dose coverage of PTV-PRVu was D95% = 40.6 Gy (40.5-40.9), D5% = 46.6 Gy (46.2-47.2) and mean dose = 44.6 Gy (44.3-44.9). Dose to the PTVt reached 44.6 Gy (41.2-45.9). Doses to the OAR were respected, except V36Gy ≤1 cc for the rectum.
A SBRT dose-escalation to 5 × 9 Gy on the prostate while sparing the urethra + 2 mm at 36.25 Gy is feasible without compromising dose coverage to the tumor. This radiation regimen will be used for a Phase-III trial.
In prostate SBRT, dose optimization on the urethra is feasible and could decrease urinary toxicities. |
| doi_str_mv | 10.1259/bjr.20210142 |
| format | Article |
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The prostate, the urethra and the tumors were delineated on 20 dosimetric CT-scans with MRI-registration. The planning target volume (PTVp) was defined as a 5 mm expansion (3 mm posteriorly) of the prostate. The planning at risk volume (PRVu) was defined as a 2 mm expansion of the urethra. The tumors were delineated on the MRI (GTVt) and a 3 mm-margin was added to create a tumoral planning target volume (PTVt). IMRT plans were optimized to deliver 5 × 9 Gy to the PTVp, limiting the dose to the PRVu to 5 × 7.25 Gy. Results are presented using average (range) values.
PTVp doses were D98% = 36.2 Gy (35.6-36.8), D2% = 46.9 Gy (46.5-47.5) and mean dose = 44.1 Gy (43.8-44.5). The dose to the PRVu was within tolerance limits for all 20 patients: V34.4Gy = 99.8% (99.2-100) and D5% = 38.7 Gy (38.6-38.8). Dose coverage of PTV-PRVu was D95% = 40.6 Gy (40.5-40.9), D5% = 46.6 Gy (46.2-47.2) and mean dose = 44.6 Gy (44.3-44.9). Dose to the PTVt reached 44.6 Gy (41.2-45.9). Doses to the OAR were respected, except V36Gy ≤1 cc for the rectum.
A SBRT dose-escalation to 5 × 9 Gy on the prostate while sparing the urethra + 2 mm at 36.25 Gy is feasible without compromising dose coverage to the tumor. This radiation regimen will be used for a Phase-III trial.
In prostate SBRT, dose optimization on the urethra is feasible and could decrease urinary toxicities.</description><identifier>ISSN: 0007-1285</identifier><identifier>EISSN: 1748-880X</identifier><identifier>DOI: 10.1259/bjr.20210142</identifier><identifier>PMID: 34283647</identifier><language>eng</language><publisher>England: The British Institute of Radiology</publisher><subject>Feasibility Studies ; Humans ; Magnetic Resonance Imaging - methods ; Male ; Organ Sparing Treatments - methods ; Prostate - diagnostic imaging ; Prostatic Neoplasms - diagnostic imaging ; Prostatic Neoplasms - radiotherapy ; Radiosurgery - methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy, Intensity-Modulated - methods ; Tomography, X-Ray Computed - methods ; Urethra - diagnostic imaging</subject><ispartof>British journal of radiology, 2021-11, Vol.94 (1127), p.20210142-20210142</ispartof><rights>2021 The Authors. Published by the British Institute of Radiology 2021 The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-be583c9880638064eca0f1ddcd5e344ad2935b65acabc96cc0aff25db8a270133</citedby><cites>FETCH-LOGICAL-c384t-be583c9880638064eca0f1ddcd5e344ad2935b65acabc96cc0aff25db8a270133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34283647$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Benhmida, Salim</creatorcontrib><creatorcontrib>Beneux, Amandine</creatorcontrib><creatorcontrib>Udrescu, Corina</creatorcontrib><creatorcontrib>Rouviere, Olivier</creatorcontrib><creatorcontrib>Horn, Samy</creatorcontrib><creatorcontrib>Enachescu, Ciprian</creatorcontrib><creatorcontrib>Lapierre, Ariane</creatorcontrib><creatorcontrib>Chapet, Olivier</creatorcontrib><title>Dosimetric feasibility of stereotactic irradiation of primary prostate cancer at 5x9 Gy with a method of urethral sparing</title><title>British journal of radiology</title><addtitle>Br J Radiol</addtitle><description>The most commonly used dose for prostate cancer stereotactic body radiotherapy (SBRT) is 5 × 7.25 Gy. The aim of this study was to evaluate the dosimetric feasibility of a 5 × 9 Gy SBRT regimen while still limiting the dose to the urethra to 5 × 7.25 Gy. This dosimetric study is part of the groundwork for a future Phase III randomized trial.
The prostate, the urethra and the tumors were delineated on 20 dosimetric CT-scans with MRI-registration. The planning target volume (PTVp) was defined as a 5 mm expansion (3 mm posteriorly) of the prostate. The planning at risk volume (PRVu) was defined as a 2 mm expansion of the urethra. The tumors were delineated on the MRI (GTVt) and a 3 mm-margin was added to create a tumoral planning target volume (PTVt). IMRT plans were optimized to deliver 5 × 9 Gy to the PTVp, limiting the dose to the PRVu to 5 × 7.25 Gy. Results are presented using average (range) values.
PTVp doses were D98% = 36.2 Gy (35.6-36.8), D2% = 46.9 Gy (46.5-47.5) and mean dose = 44.1 Gy (43.8-44.5). The dose to the PRVu was within tolerance limits for all 20 patients: V34.4Gy = 99.8% (99.2-100) and D5% = 38.7 Gy (38.6-38.8). Dose coverage of PTV-PRVu was D95% = 40.6 Gy (40.5-40.9), D5% = 46.6 Gy (46.2-47.2) and mean dose = 44.6 Gy (44.3-44.9). Dose to the PTVt reached 44.6 Gy (41.2-45.9). Doses to the OAR were respected, except V36Gy ≤1 cc for the rectum.
A SBRT dose-escalation to 5 × 9 Gy on the prostate while sparing the urethra + 2 mm at 36.25 Gy is feasible without compromising dose coverage to the tumor. This radiation regimen will be used for a Phase-III trial.
In prostate SBRT, dose optimization on the urethra is feasible and could decrease urinary toxicities.</description><subject>Feasibility Studies</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Organ Sparing Treatments - methods</subject><subject>Prostate - diagnostic imaging</subject><subject>Prostatic Neoplasms - diagnostic imaging</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radiosurgery - methods</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted - methods</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Urethra - diagnostic imaging</subject><issn>0007-1285</issn><issn>1748-880X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUU1LAzEQDaLYWr15lhw9uJqPzTZ7EaR-QsGLgrcwm83alO2mJqnaf2-WtqKHMBnemzcfD6FTSi4pE-VVNfeXjDBKaM720JCOc5lJSd720ZAQMs4ok2KAjkKY96koySEa8JxJXuTjIVrfumAXJnqrcWMg2Mq2Nq6xa3CIxhsXQceEWe-hthCt63ps6e0C_DpFFyJEgzV02ngMEYvvEj-s8ZeNMww4Sc9c3ZesfPp6aHFYgrfd-zE6aKAN5mQbR-j1_u5l8phNnx-eJjfTTHOZx6wyQnJdpo0Knl5uNJCG1rWuheF5DjUruagKARoqXRZaE2gaJupKAhsTyvkIXW90l6tqYWptupimUNsNlAOr_iOdnal396mkEJyWNAmcbwW8-1iZENXCBm3aFjrjVkGxxJOMFkXf62JD1ekuwZvmtw0lqndLJbfUzq1EP_s72i95Zw__AToWlDU</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Benhmida, Salim</creator><creator>Beneux, Amandine</creator><creator>Udrescu, Corina</creator><creator>Rouviere, Olivier</creator><creator>Horn, Samy</creator><creator>Enachescu, Ciprian</creator><creator>Lapierre, Ariane</creator><creator>Chapet, Olivier</creator><general>The British Institute of Radiology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211101</creationdate><title>Dosimetric feasibility of stereotactic irradiation of primary prostate cancer at 5x9 Gy with a method of urethral sparing</title><author>Benhmida, Salim ; Beneux, Amandine ; Udrescu, Corina ; Rouviere, Olivier ; Horn, Samy ; Enachescu, Ciprian ; Lapierre, Ariane ; Chapet, Olivier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-be583c9880638064eca0f1ddcd5e344ad2935b65acabc96cc0aff25db8a270133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Feasibility Studies</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Organ Sparing Treatments - methods</topic><topic>Prostate - diagnostic imaging</topic><topic>Prostatic Neoplasms - diagnostic imaging</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radiosurgery - methods</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Urethra - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benhmida, Salim</creatorcontrib><creatorcontrib>Beneux, Amandine</creatorcontrib><creatorcontrib>Udrescu, Corina</creatorcontrib><creatorcontrib>Rouviere, Olivier</creatorcontrib><creatorcontrib>Horn, Samy</creatorcontrib><creatorcontrib>Enachescu, Ciprian</creatorcontrib><creatorcontrib>Lapierre, Ariane</creatorcontrib><creatorcontrib>Chapet, Olivier</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Benhmida, Salim</au><au>Beneux, Amandine</au><au>Udrescu, Corina</au><au>Rouviere, Olivier</au><au>Horn, Samy</au><au>Enachescu, Ciprian</au><au>Lapierre, Ariane</au><au>Chapet, Olivier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dosimetric feasibility of stereotactic irradiation of primary prostate cancer at 5x9 Gy with a method of urethral sparing</atitle><jtitle>British journal of radiology</jtitle><addtitle>Br J Radiol</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>94</volume><issue>1127</issue><spage>20210142</spage><epage>20210142</epage><pages>20210142-20210142</pages><issn>0007-1285</issn><eissn>1748-880X</eissn><abstract>The most commonly used dose for prostate cancer stereotactic body radiotherapy (SBRT) is 5 × 7.25 Gy. The aim of this study was to evaluate the dosimetric feasibility of a 5 × 9 Gy SBRT regimen while still limiting the dose to the urethra to 5 × 7.25 Gy. This dosimetric study is part of the groundwork for a future Phase III randomized trial.
The prostate, the urethra and the tumors were delineated on 20 dosimetric CT-scans with MRI-registration. The planning target volume (PTVp) was defined as a 5 mm expansion (3 mm posteriorly) of the prostate. The planning at risk volume (PRVu) was defined as a 2 mm expansion of the urethra. The tumors were delineated on the MRI (GTVt) and a 3 mm-margin was added to create a tumoral planning target volume (PTVt). IMRT plans were optimized to deliver 5 × 9 Gy to the PTVp, limiting the dose to the PRVu to 5 × 7.25 Gy. Results are presented using average (range) values.
PTVp doses were D98% = 36.2 Gy (35.6-36.8), D2% = 46.9 Gy (46.5-47.5) and mean dose = 44.1 Gy (43.8-44.5). The dose to the PRVu was within tolerance limits for all 20 patients: V34.4Gy = 99.8% (99.2-100) and D5% = 38.7 Gy (38.6-38.8). Dose coverage of PTV-PRVu was D95% = 40.6 Gy (40.5-40.9), D5% = 46.6 Gy (46.2-47.2) and mean dose = 44.6 Gy (44.3-44.9). Dose to the PTVt reached 44.6 Gy (41.2-45.9). Doses to the OAR were respected, except V36Gy ≤1 cc for the rectum.
A SBRT dose-escalation to 5 × 9 Gy on the prostate while sparing the urethra + 2 mm at 36.25 Gy is feasible without compromising dose coverage to the tumor. This radiation regimen will be used for a Phase-III trial.
In prostate SBRT, dose optimization on the urethra is feasible and could decrease urinary toxicities.</abstract><cop>England</cop><pub>The British Institute of Radiology</pub><pmid>34283647</pmid><doi>10.1259/bjr.20210142</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Feasibility Studies Humans Magnetic Resonance Imaging - methods Male Organ Sparing Treatments - methods Prostate - diagnostic imaging Prostatic Neoplasms - diagnostic imaging Prostatic Neoplasms - radiotherapy Radiosurgery - methods Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Intensity-Modulated - methods Tomography, X-Ray Computed - methods Urethra - diagnostic imaging |
| title | Dosimetric feasibility of stereotactic irradiation of primary prostate cancer at 5x9 Gy with a method of urethral sparing |
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