Intensity-modulated radiotherapy for a prostate patient with a metal prosthesis

Med Dosim. 2001 Winter;26(4):305-8. doi: 10.1016/s0958-3947(01)00079-6.

Abstract

When treating prostate patients having a metallic prosthesis with radiation, a 3D conformal radiotherapy (3DCRT) treatment plan is commonly created using only those fields that avoid the prosthesis in the beam's-eye view (BEV). With a limited number of portals, the resulting plan may compromise the dose sparing of the rectum and bladder. In this work, we investigate the feasibility of using intensity-modulated radiotherapy (IMRT) to treat prostate patients having a metallic prosthesis. Three patients, each with a single metallic prosthesis, who were previously treated at the University of Chicago Medical Center for prostate cancer, were selected for this study. Clinical target volumes (CTV = prostate + seminal vesicles), bladder, and rectum volumes were identified on CT slices. Planning target volumes (PTV) were generated in 3D by a 1-cm expansion of the CTVs. For these comparative studies, treatment plans were generated from CT data using 3DCRT and IMRT treatment planning systems. The IMRT plans used 9 equally-spaced 6-MV coplanar fields, with each field avoiding the prosthesis. The 3DCRT plans used 5 coplanar 18-MV fields, with each field avoiding the prosthesis. A 1-cm margin around the PTV was used for the blocks. Each of the 9-field IMRT plans spared the bladder and rectum better than the corresponding 3DCRT plan. In the IMRT, plans, a bladder volume receiving 80% or greater dose decreased by 20-77 cc, and a volume rectal volume receiving 80% or greater dose decreased by 24-40 cc. One negative feature of the IMRT plans was the homogeneity across the target, which ranged from 95% to 115%.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Feasibility Studies
  • Hip Prosthesis*
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Metals / radiation effects*
  • Prostate / diagnostic imaging
  • Prostate / radiation effects
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / radiotherapy*
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy, Conformal / methods*
  • Seminal Vesicles / diagnostic imaging
  • Seminal Vesicles / radiation effects
  • Tomography, X-Ray Computed
  • Urinary Bladder / diagnostic imaging
  • Urinary Bladder / radiation effects

Substances

  • Metals