Prog Med Phys.  2013 Sep;24(3):154-161. 10.14316/pmp.2013.24.3.154.

Comparison of Intensity-modulated Radiation Therapy (IMRT), Uniform Scanning Proton Therapy (USPT), and Intensity-modulated Proton Therapy (IMPT) for Prostate Cancer: A Treatment Planning Study

Affiliations
  • 1Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea.
  • 2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jinsung.k@gmail.com, youngyih@skku.edu

Abstract

This study assessed compared photon and proton treatment techniques, such as intensity modulated radiation therapy (IMRT), uniform scanning proton therapy (USPT), and intensity modulated proton therapy (IMPT), for a total of 10 prostate cancers. All treatment plans delivered 70 Gy to 95% of the planned target volume in 28 fractions. IMRT plans had 7 fields for the step and shoot technique, while USPT and IMPT plans employed two equally weighted, parallel-opposed lateral fields to deliver the prescribed dose to the planned target. Inverse planning was then incorporated to optimize IMPT. The homogeneity index (HI) and conformity index (CI) for the target and the normal tissue complication probability (NTCP) for organ at risk (OAR) were calculated. Although the mean HI and CI for target were not significantly different for each treatment techniques, the NTCP of the rectum was 2.233, 3.326, and 1.707 for IMRT, USPT, and IMPT, respectively. The NTCP of the bladder was 0.008, 0.003, and 0.002 respectively. The NTCP values at the rectum and bladder were significantly lower using IMPT. Our study shows that using proton therapy, particularly IMPT, to treat prostate cancer could be beneficial compared to 7-field IMRT with similar target coverage. Given these results, radiotherapy using protons, particularly optimized IMPT, is a worthwhile treatment option for prostate cancer.

Keyword

IMRT; USPT; IMPT; Prostate cancer; Treatment planning

MeSH Terms

Prostate*
Prostatic Neoplasms*
Proton Therapy*
Protons*
Radiotherapy
Rectum
Urinary Bladder
Protons

Figure

  • Fig. 1. Color wash IMRT (a), USPT (b), and IMPT (c) dose distribution for the PTV for patient (patient 3) with a prostate cancer. It shows the dose distributions of IMRT, USPT, and IMPT plans for CT image on axial, frontal, and sagittal planes, respectively. IMPT and USPT dose distributions delivered by right lateral (270°) and left lateral (90°) beams.

  • Fig. 2. Mean DVHs of 10 prostate patients for OARs at IMPT, USPT, and IMRT.


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