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Review
. 2010 Apr;20(2):130-7.
doi: 10.1016/j.semradonc.2009.11.007.

Adaptive radiation therapy for prostate cancer

Michel Ghilezan  1 , Di Yan, Alvaro Martinez
Affiliations
Review

Adaptive radiation therapy for prostate cancer

Michel Ghilezan et al. Semin Radiat Oncol. 2010 Apr.

Abstract

Adaptive radiotherapy has been introduced to manage an individual's treatment by, including patient-specific treatment variation identified and quantified during the course of radiotherapy in the treatment planning and delivering optimization. Early studies have demonstrated that this technique could significantly improve the therapeutic ratio by safely reducing the large target margin that has to be used in conventional radiotherapy for prostate cancer treatment. Clinical application of off-line image-guided adaptive radiotherapy for prostate cancer has demonstrated encouraging clinical outcome. Long-term clinical follow-up has shown significant improvement in terms of tumor control and low toxicity profile, emphasizing the beneficial effect of image-guidance and adaptive treatment. Continuous development in adaptive radiotherapy has made possible additional increases in target dose by further reducing target margin when using online image-guided adaptive intensity-modulated radiation therapy. However, clinical implementation of new techniques should be explored cautiously and should include a comprehensive management strategy to address uncertainties in target definition and delineation in the preclinical implementation studies.

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Figures

Figure 1
Figure 1
Flow chart depicting the off-line image guided adaptive radiation therapy process.
Figure 2
Figure 2
Error bar indicates the mean and 1 standard deviation of maximum dose reduction for a given number of computed tomography measurements. The maximum dose reduction (% of Rx. dose) in the clinical target volume due to internal target motion when the patient specific target was applied was estimated considering the worst situation.
Figure 3
Figure 3
Distribution of the prescription dose for the patients treated using either a 4-field conformal radiation therapy or a 5-beam intensity-modulated radiation therapy in the off-line adaptive process.
Figure 4
Figure 4
Actuarial Phoenix Biochemical Control (nadir + 2 ng/mL).
See this image and copyright information in PMC

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