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Development of a simultaneous boost IMRT class solution for a hypofractionated prostate cancer protocol

¹ North Western Medical Physics and ² Clinical Oncology, Christie Hospital NHS Trust, Manchester M20 4BX, UK

View larger version (67K): [in a new window]   Figure 1. Volumes used for planning prostate patients. At this level clinical target volume (CTV)1=CTV2, although these volumes separate as the seminal vesicles appear. The picture on the right illustrates how the overlap priorities govern which volume individual pixels are assigned to during the optimization of the intensity-modulated radiation therapy (IMRT) plans. PTV, planning target volume.

View larger version (94K): [in a new window]   Figure 2. Dose distributions for a central slice of a typical patient: (a) the intensity-modulated radiation therapy (IMRT) simultaneous boost technique—isodoses represent 95% of the prescribed planning target volume (PTV) dose (50 Gy) and 95% of the prostate boost dose (57 Gy); (b) phase 1 of the 3D conformal radiotherapy (3DCRT) sequential boost technique (isodose 95% of 48 Gy PTV dose); (c) phase 2 of the 3DCRT technique (isodose 95% of 9 Gy boost volume dose). In all cases the contours outlined are the clinical target volume (CTV) (at this level CTV1=CTV2), PTV, bladder (bl) and rectum (rec).

View larger version (12K): [in a new window]   Figure 3. Percentage volumes of (a) the rectum and (b) rectum2 irradiated to 45.0 Gy, 47.5 Gy (95% of the planning target volume nominal dose) and 54.2 Gy (95% of the prostate boost dose) for the intensity-modulated radiation therapy (IMRT) and 3D conformal radiotherapy (3DCRT) techniques.

View larger version (18K): [in a new window]   Figure 4. Dose–volume histograms (DVHs) for a typical prostate patient. Solid lines indicate the 57 Gy intensity-modulated radiation therapy (IMRT) technique, dashed lines the 3D conformal radiotherapy (3DCRT) technique. DVHs are shown for (a) the prostate (clinical target volume (CTV)2) and planning target volume (PTV); (b) bladder (bl); (c) rectum (rec) and (d) left femoral head (fhl).