CyberKnife Ultra-Hypofractionated SBRT for Localized Prostate Cancer with Dose Escalation to the Dominant Intraprostatic Lesion: In Silico Planning Study
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Published:2023-06-19
Issue:12
Volume:13
Page:7273
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ISSN:2076-3417
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Container-title:Applied Sciences
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language:en
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Short-container-title:Applied Sciences
Author:
Mazzola Giovanni Carlo12ORCID, Vincini Maria Giulia1ORCID, Rondi Elena3, Ronci Giuseppe3, Vigorito Sabrina3ORCID, Zaffaroni Mattia1ORCID, Corrao Giulia1ORCID, Gallo Salvatore4ORCID, Zerini Dario1, Durante Stefano1ORCID, Mistretta Francesco Alessandro5ORCID, Luzzago Stefano25, Ferro Matteo5ORCID, Vavassori Andrea1ORCID, Cattani Federica3, Musi Gennaro25, De Cobelli Ottavio25, Petralia Giuseppe26, Orecchia Roberto7, Marvaso Giulia12ORCID, Jereczek-Fossa Barbara Alicja12
Affiliation:
1. Division of Radiation Oncology, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy 2. Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy 3. Unit of Medical Physics, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy 4. Department of Physics “Aldo Pontremoli”, University of Milan, 20133 Milan, Italy 5. Division of Urology, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy 6. Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy 7. Scientific Directorate, European Institute of Oncology (IEO) IRCCS, 20141 Milan, Italy
Abstract
The aim is to evaluate the feasibility of ultra-hypofractionated (UH) SBRT with CyberKnife® (CK) radiosurgery (Accuray Inc., Sunnyvale, California, USA) for localized prostate cancer (PCa) with a concomitant focal boost to the dominant intraprostatic lesion (DIL). Patients with intermediate/high-risk PCa, with at least one visible DIL on multi-parametric MRI, were included. For each, two CK-SBRT in silico plans were calculated using 95% and 85% isodose lines (CK-95%, CK-85%) and compared with the UH-DWA plan delivered with VERO®. All plans simulated a SIB prescription of 40 Gy to PTV-DIL and 36.25 Gy to the whole prostate (PTV-prostate) in five fractions every other day. Fifteen patients were considered. All plans reached the primary planning goal (D95% > 95%) and compliance with organs at risk (OARs) constraints. DVH metrics median values increased (p < 0.05) from UH-DWA to CK-85%. The conformity index of PTV-DIL was 1.00 for all techniques, while for PTV-prostate was 0.978, 0.984, and 0.991 for UH-DWA, CK-95%, and CK-85%, respectively. The CK-85% plans were able to reach a maximum dose of 47 Gy to the DIL while respecting OARs constraints. CK-SBRT plus a focal boost to the DIL for localized PCa appears to be feasible. These encouraging dosimetric results are to be confirmed in upcoming clinical trials such as the phase-II “PRO-SPEED” IEO trial.
Funder
the Italian Ministry of Health AIRC Fondazione IEO-CCM the “Associazione Italiana per la Ricerca sul Cancro—AIRC”
Subject
Fluid Flow and Transfer Processes,Computer Science Applications,Process Chemistry and Technology,General Engineering,Instrumentation,General Materials Science
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