Rotational radiotherapy for prostate cancer in clinical practice

Marianne Aznar, Per Munck af Rosenschöld, Ashildur Logadottir, Henriette Lindberg, Stine Korreman, Flemming Kjær-Kristoffersen, Svend Aage Engelholm

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Resumé

    Background and purpose
    Radiotherapy is the standard treatment in locally advanced prostate cancer. The latest technological improvement is modulated rotational radiotherapy, where one single rotation of the treatment machine is used to conform the dose delivery to the target and spare organs at risk, requiring less than 2min of beam-on time per treatment fraction.

    Materials and methods
    We report herein our experience from the first 46 patients treated for prostate cancer, clinical stage T1–3 with rotational therapy (“RapidArc®”, Varian Medical systems) (RA). This patient group is compared to a group of 50 patients treated with a 5-field Intensity Modulated Radiation Therapy (IMRT) technique over the same period. The comparison parameters include target coverage, dose to OAR, treatment time and number of monitor units. Daily-IGRT using implanted gold markers is used before and after treatment to investigate intra-fractional prostate displacement.

    Results
    RA results in improved sparing of the rectum and achieves desired dose distributions with fewer monitor units and a shorter treatment time (<1.5min versus up to 8.9min with IMRT). This shorter treatment time also translates in a decreased risk of patient motion during treatment: daily-IGRT demonstrates reduced prostate motion (<3mm 3D vector) from 16.7% to 4.7% in RA patients. Only slight side-effects were seen in the two groups of patients.

    Conclusions
    RA results in improved sparing of the rectum, however, at the expense of an increase in dose to the femoral heads in prostate patients. The treatment time is significantly reduced from 4.9min on average with 5-field IMRT to 1.1min with RA, which allows for a reduction of infractional prostate motion.
    OriginalsprogEngelsk
    TidsskriftRadiotherapy & Oncology
    Vol/bind97
    Udgave nummer3
    Sider (fra-til)480-484
    ISSN0167-8140
    DOI
    StatusUdgivet - dec. 2010

    Citer dette

    Aznar, M., Munck af Rosenschöld, P., Logadottir, A., Lindberg, H., Korreman, S., Kjær-Kristoffersen, F., & Engelholm, S. A. (2010). Rotational radiotherapy for prostate cancer in clinical practice. Radiotherapy & Oncology, 97(3), 480-484. https://doi.org/10.1016/j.radonc.2010.09.014
    Aznar, Marianne ; Munck af Rosenschöld, Per ; Logadottir, Ashildur ; Lindberg, Henriette ; Korreman, Stine ; Kjær-Kristoffersen, Flemming ; Engelholm, Svend Aage. / Rotational radiotherapy for prostate cancer in clinical practice. I: Radiotherapy & Oncology. 2010 ; Bind 97, Nr. 3. s. 480-484.
    @article{ee23411a48084f75b08e6e5dd8ea49b4,
    title = "Rotational radiotherapy for prostate cancer in clinical practice",
    abstract = "Background and purpose Radiotherapy is the standard treatment in locally advanced prostate cancer. The latest technological improvement is modulated rotational radiotherapy, where one single rotation of the treatment machine is used to conform the dose delivery to the target and spare organs at risk, requiring less than 2min of beam-on time per treatment fraction. Materials and methods We report herein our experience from the first 46 patients treated for prostate cancer, clinical stage T1–3 with rotational therapy (“RapidArc{\circledR}”, Varian Medical systems) (RA). This patient group is compared to a group of 50 patients treated with a 5-field Intensity Modulated Radiation Therapy (IMRT) technique over the same period. The comparison parameters include target coverage, dose to OAR, treatment time and number of monitor units. Daily-IGRT using implanted gold markers is used before and after treatment to investigate intra-fractional prostate displacement. Results RA results in improved sparing of the rectum and achieves desired dose distributions with fewer monitor units and a shorter treatment time (<1.5min versus up to 8.9min with IMRT). This shorter treatment time also translates in a decreased risk of patient motion during treatment: daily-IGRT demonstrates reduced prostate motion (<3mm 3D vector) from 16.7{\%} to 4.7{\%} in RA patients. Only slight side-effects were seen in the two groups of patients. Conclusions RA results in improved sparing of the rectum, however, at the expense of an increase in dose to the femoral heads in prostate patients. The treatment time is significantly reduced from 4.9min on average with 5-field IMRT to 1.1min with RA, which allows for a reduction of infractional prostate motion.",
    keywords = "Prostate cancer, Modulated rotational therapy, IMRT, RapidArc",
    author = "Marianne Aznar and {Munck af Rosensch{\"o}ld}, Per and Ashildur Logadottir and Henriette Lindberg and Stine Korreman and Flemming Kj{\ae}r-Kristoffersen and Engelholm, {Svend Aage}",
    year = "2010",
    month = "12",
    doi = "10.1016/j.radonc.2010.09.014",
    language = "English",
    volume = "97",
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    Aznar, M, Munck af Rosenschöld, P, Logadottir, A, Lindberg, H, Korreman, S, Kjær-Kristoffersen, F & Engelholm, SA 2010, 'Rotational radiotherapy for prostate cancer in clinical practice', Radiotherapy & Oncology, bind 97, nr. 3, s. 480-484. https://doi.org/10.1016/j.radonc.2010.09.014

    Rotational radiotherapy for prostate cancer in clinical practice. / Aznar, Marianne; Munck af Rosenschöld, Per; Logadottir, Ashildur; Lindberg, Henriette; Korreman, Stine; Kjær-Kristoffersen, Flemming; Engelholm, Svend Aage.

    I: Radiotherapy & Oncology, Bind 97, Nr. 3, 12.2010, s. 480-484.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Rotational radiotherapy for prostate cancer in clinical practice

    AU - Aznar, Marianne

    AU - Munck af Rosenschöld, Per

    AU - Logadottir, Ashildur

    AU - Lindberg, Henriette

    AU - Korreman, Stine

    AU - Kjær-Kristoffersen, Flemming

    AU - Engelholm, Svend Aage

    PY - 2010/12

    Y1 - 2010/12

    N2 - Background and purpose Radiotherapy is the standard treatment in locally advanced prostate cancer. The latest technological improvement is modulated rotational radiotherapy, where one single rotation of the treatment machine is used to conform the dose delivery to the target and spare organs at risk, requiring less than 2min of beam-on time per treatment fraction. Materials and methods We report herein our experience from the first 46 patients treated for prostate cancer, clinical stage T1–3 with rotational therapy (“RapidArc®”, Varian Medical systems) (RA). This patient group is compared to a group of 50 patients treated with a 5-field Intensity Modulated Radiation Therapy (IMRT) technique over the same period. The comparison parameters include target coverage, dose to OAR, treatment time and number of monitor units. Daily-IGRT using implanted gold markers is used before and after treatment to investigate intra-fractional prostate displacement. Results RA results in improved sparing of the rectum and achieves desired dose distributions with fewer monitor units and a shorter treatment time (<1.5min versus up to 8.9min with IMRT). This shorter treatment time also translates in a decreased risk of patient motion during treatment: daily-IGRT demonstrates reduced prostate motion (<3mm 3D vector) from 16.7% to 4.7% in RA patients. Only slight side-effects were seen in the two groups of patients. Conclusions RA results in improved sparing of the rectum, however, at the expense of an increase in dose to the femoral heads in prostate patients. The treatment time is significantly reduced from 4.9min on average with 5-field IMRT to 1.1min with RA, which allows for a reduction of infractional prostate motion.

    AB - Background and purpose Radiotherapy is the standard treatment in locally advanced prostate cancer. The latest technological improvement is modulated rotational radiotherapy, where one single rotation of the treatment machine is used to conform the dose delivery to the target and spare organs at risk, requiring less than 2min of beam-on time per treatment fraction. Materials and methods We report herein our experience from the first 46 patients treated for prostate cancer, clinical stage T1–3 with rotational therapy (“RapidArc®”, Varian Medical systems) (RA). This patient group is compared to a group of 50 patients treated with a 5-field Intensity Modulated Radiation Therapy (IMRT) technique over the same period. The comparison parameters include target coverage, dose to OAR, treatment time and number of monitor units. Daily-IGRT using implanted gold markers is used before and after treatment to investigate intra-fractional prostate displacement. Results RA results in improved sparing of the rectum and achieves desired dose distributions with fewer monitor units and a shorter treatment time (<1.5min versus up to 8.9min with IMRT). This shorter treatment time also translates in a decreased risk of patient motion during treatment: daily-IGRT demonstrates reduced prostate motion (<3mm 3D vector) from 16.7% to 4.7% in RA patients. Only slight side-effects were seen in the two groups of patients. Conclusions RA results in improved sparing of the rectum, however, at the expense of an increase in dose to the femoral heads in prostate patients. The treatment time is significantly reduced from 4.9min on average with 5-field IMRT to 1.1min with RA, which allows for a reduction of infractional prostate motion.

    KW - Prostate cancer

    KW - Modulated rotational therapy

    KW - IMRT

    KW - RapidArc

    U2 - 10.1016/j.radonc.2010.09.014

    DO - 10.1016/j.radonc.2010.09.014

    M3 - Journal article

    VL - 97

    SP - 480

    EP - 484

    JO - Radiotherapy & Oncology

    JF - Radiotherapy & Oncology

    SN - 0167-8140

    IS - 3

    ER -

    Aznar M, Munck af Rosenschöld P, Logadottir A, Lindberg H, Korreman S, Kjær-Kristoffersen F et al. Rotational radiotherapy for prostate cancer in clinical practice. Radiotherapy & Oncology. 2010 dec;97(3):480-484. https://doi.org/10.1016/j.radonc.2010.09.014