Radiat Oncol J.  2013 Jun;31(2):104-110. 10.3857/roj.2013.31.2.104.

Comparison study of intensity modulated arc therapy using single or multiple arcs to intensity modulated radiation therapy for high-risk prostate cancer

• Ashamalla
• Tejwani A
• Parameritis I
• Swamy U
• Luo PC
• Guirguis A
• Lavaf A

• KMID: 2051125
• DOI: http://doi.org/10.3857/roj.2013.31.2.104

Abstract

PURPOSE
Intensity modulated arc therapy (IMAT) is a form of intensity modulated radiation therapy (IMRT) that delivers dose in single or multiple arcs. We compared IMRT plans versus single-arc field (1ARC) and multi-arc fields (3ARC) IMAT plans in high-risk prostate cancer.
MATERIALS AND METHODS
Sixteen patients were studied. Prostate (PTVP), right pelvic (PTVRtLN) and left pelvic lymph nodes (PTVLtLN), and organs at risk were contoured. PTVP, PTVRtLN, and PTVLtLN received 50.40 Gy followed by a boost to PTVB of 28.80 Gy. Three plans were per patient generated: IMRT, 1ARC, and 3ARC. We recorded the dose to the PTV, the mean dose (DMEAN) to the organs at risk, and volume covered by the 50% isodose. Efficiency was evaluated by monitor units (MU) and beam on time (BOT). Conformity index (CI), Paddick gradient index, and homogeneity index (HI) were also calculated.
RESULTS
Average Radiation Therapy Oncology Group CI was 1.17, 1.20, and 1.15 for IMRT, 1ARC, and 3ARC, respectively. The plans' HI were within 1% of each other. The DMEAN of bladder was within 2% of each other. The rectum DMEAN in IMRT plans was 10% lower dose than the arc plans (p < 0.0001). The GI of the 3ARC was superior to IMRT by 27.4% (p = 0.006). The average MU was highest in the IMRT plans (1686) versus 1ARC (575) versus 3ARC (1079). The average BOT was 6 minutes for IMRT compared to 1.3 and 2.9 for 1ARC and 3ARC IMAT (p < 0.05).
CONCLUSION
For high-risk prostate cancer, IMAT may offer a favorable dose gradient profile, conformity, MU and BOT compared to IMRT.

Keyword

High risk prostate cancer; Intensity modulated arc therapy; Intensity modulated radiation therapy; RapidArc

MeSH Terms

Humans
Lymph Nodes
Organothiophosphorus Compounds
Organs at Risk
Prostate
Prostatic Neoplasms
Radiotherapy, Intensity-Modulated
Rectum
Urinary Bladder
Organothiophosphorus Compounds