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Mixed-beam approach for high-risk prostate cancer: Carbon-ion boost followed by photon intensity-modulated radiotherapy. Dosimetric and geometric evaluations (AIRC IG-14300).
Gugliandolo, Simone Giovanni; Marvaso, Giulia; Comi, Stefania; Pepa, Matteo; Romanò, Chiara; Zerini, Dario; Augugliaro, Matteo; Russo, Stefania; Vischioni, Barbara; Valvo, Francesca; Giandini, Tommaso; Avuzzi, Barbara; Valdagni, Riccardo; Ciardo, Delia; De Cobelli, Ottavio; Jereczek-Fossa, Barbara Alicja; Cattani, Federica; Orecchia, Roberto.
Afiliação
  • Gugliandolo SG; Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
  • Marvaso G; Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy.
  • Comi S; Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
  • Pepa M; Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy. Electronic address: matteo.pepa@ieo.it.
  • Romanò C; Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
  • Zerini D; Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
  • Augugliaro M; Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
  • Russo S; Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Str. Campeggi, 53, 27100, Pavia, Italy.
  • Vischioni B; Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Str. Campeggi, 53, 27100, Pavia, Italy.
  • Valvo F; Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Str. Campeggi, 53, 27100, Pavia, Italy.
  • Giandini T; Unit of Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy.
  • Avuzzi B; Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy.
  • Valdagni R; Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy.
  • Ciardo D; Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
  • De Cobelli O; Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy; Division of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
  • Jereczek-Fossa BA; Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy.
  • Cattani F; Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
  • Orecchia R; Scientific Directorate, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
Phys Med ; 76: 327-336, 2020 Aug.
Article em En | MEDLINE | ID: mdl-32750548
ABSTRACT
BACKGROUND AND

PURPOSE:

The aim was to evaluate dosimetric uncertainties of a mixed beam approach for patients with high-risk prostate cancer (PCa). The treatment consists of a carbon ion radiotherapy (CIRT) boost followed by whole-pelvis intensity-modulated RT (IMRT). MATERIALS AND

METHODS:

Patients were treated with a CIRT boost of 16.6 Gy/4 fractions followed by whole-pelvis IMRT of 50 Gy/25 fractions, with consequent long term androgen deprivation therapy. Deformable computed tomography image registration (DIR) was performed and corresponding doses were used for plan sum. A comparative IMRT photon plan was obtained as whole-pelvis IMRT of 50 Gy/25 fractions followed by a boost of 28 Gy/14 fractions. DIR performances were evaluated through structure-related and image characteristics parameters.

RESULTS:

Until now, five patients out of ten total enrolled ended the treatment. Dosimetric parameters were lower in CIRT + IMRT than IMRT-only plans for all organs at risk (OARs) except femoral heads. Regarding DIR evaluation, femoral heads were the less deformed OAR. Penile bulb, bladder and anal canal showed intermediate deformation. Rectum was the most deformed. DIR algorithms were patient (P)-dependent, as performances were the highest for P3 and P4, intermediate for P2 and P5, and the lowest for P1.

CONCLUSIONS:

CIRT allows better OARs sparing while increasing the efficacy due to the higher radio-biological effect of carbon ions. However, a mixed beam approach could introduce DIR problems in multi-centric treatments with different operative protocols. The development of this prospective trial will lead to more mature data concerning the clinical impact of implementing DIR procedures in dose accumulation applications for high-risk PCa treatments.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Radioterapia de Intensidade Modulada Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Limite: Humans / Male Idioma: En Revista: Phys Med Assunto da revista: BIOFISICA / BIOLOGIA / MEDICINA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Radioterapia de Intensidade Modulada Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Limite: Humans / Male Idioma: En Revista: Phys Med Assunto da revista: BIOFISICA / BIOLOGIA / MEDICINA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Itália
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