Journal article
A novel external beam radiotherapy method for cervical cancer patients using virtual straight or bending boost areas; an in-silico feasibility study
Radiation oncology (London, England), v 16(1), 110
14 Jun 2021
PMID: 34127013
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Aim To investigate the potential role of a novel spatially fractionated radiation therapy (SFRT) method where heterogeneous dose patterns are created in target areas with virtual rods, straight or curving, of variable position, diameter, separation and alignment personalised to a patient's anatomy. The images chosen for this study were CT scans acquired for the external beam part of radiotherapy. Methods Ten patients with locally advanced cervical cancer were retrospectively investigated with SFRT. The dose prescription was 30 Gy in 5 fractions to 90% target volume coverage. Peak-and-valley (SFRT_1) and peak-only (SFRT_2) strategies were applied to generate the heterogeneous dose distributions. The planning objectives for the target (CTV) were D-90% >= 30 Gy, V-45Gy >= 50-55% and V-60Gy >= 30%. The planning objectives for the organs at risk (OAR) were: D-2cm3 <= 23.75 Gy, 17.0 Gy, 19.5 Gy, 17.0 Gy for the bladder, rectum, sigmoid and bowel, respectively. The plan comparison was performed employing the quantitative analysis of the dose-volume histograms. Results The D-2cm3 was 22.4 +/- 2.0 (22.6 +/- 2.1) and 13.9 +/- 2.9 (13.2 +/- 3.0) for the bladder and the rectum for SFRT_1 (SFRT_2). The results for the sigmoid and the bowel were 2.6 +/- 3.1 (2.8 +/- 3.0) and 9.1 +/- 5.9 (9.7 +/- 7.3), respectively. The hotspots in the target volume were V-45Gy = 43.1 +/- 7.5% (56.6 +/- 5.6%) and V-60Gy = 15.4 +/- 5.6% (26.8 +/- 6.6%) for SFRT_1 (SFRT_2). To account for potential uncertainties in the positioning, the dose prescription could be escalated to D-90% = 33-35 Gy to the CTV without compromising any constraints to the OARs Conclusion In this dosimetric study, the proposed novel planning technique for boosting the cervix uteri was associated with high-quality plans, respecting constraints for the organs at risk and approaching the level of dose heterogeneity achieved with routine brachytherapy. Based on a sample of 10 patients, the results are promising and might lead to a phase I clinical trial.
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Details
- Title
- A novel external beam radiotherapy method for cervical cancer patients using virtual straight or bending boost areas; an in-silico feasibility study
- Creators
- Luca Cozzi - IRCCS Humanitas Research HospitalSushil Beriwal - UPMC Hillman Cancer CenterEsa Kuusela - College Station Medical CenterSupriya Chopra - Advanced Centre for Treatment, Research and Education in CancerHester Burger - Groote Schuur HospitalNanette Joubert - Groote Schuur HospitalAntonella Fogliata - IRCCS Humanitas Research HospitalJai Prakash Agarwal - Homi Bhabha National InstitutePat Kupelian - University of California, Los Angeles
- Publication Details
- Radiation oncology (London, England), v 16(1), 110
- Publisher
- Springer Nature
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000661493900001
- Scopus ID
- 2-s2.0-85107887743
- Other Identifier
- 991021897387804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging