Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2010 Jun 16:5:54.
doi: 10.1186/1748-717X-5-54.

Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy

Gianfranco A Pesce  1 , Alessandro Clivio, Luca Cozzi, Giorgia Nicolini, Antonella Richetti, Emanuela Salati, Mariacarla Valli, Eugenio Vanetti, Antonella Fogliata
Affiliations
Clinical Trial

Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy

Gianfranco A Pesce et al. Radiat Oncol. .

Abstract

Background: To report about initial clinical experience in radiation treatment of carcinoma of prostate with volumetric modulated arcs with the RapidArc (RA) technology.

Methods: Forty-five patients with a median age of 72 +/- 3, affected by prostate carcinoma (T1c: 22 patients, T2a-b: 17 patients, T3a-b: 6 patients. N0: 43 patients, N1-Nx: 2 patients, all M0), with initial PSA of 10.0 +/- 3.0 ng/mL, were treated with RapidArc in a feasibility study. All patients were treated with single arc using 6MV photons. Dose prescription ranged between 76 (7 patients) and 78 Gy (38 patients) in 2 Gy/fraction. Plan quality was assessed by means of Dose Volume Histogram (DVH) analysis. Technical parameters of arcs and pre-treatment quality assurance results (Gamma Agreement Index, GAI) are reported to describe delivery features. Early toxicity was scored (according to the Common Terminology Criteria of Adverse Effects scale, CTCAE, scale) at the end of treatment together with biochemical outcome (PSA).

Results: From DVH data, target coverage was fulfilling planning objectives: V95% was in average higher than 98% and V107% approximately 0.0% (D2% approximately 104.0% in average). Homogeneity D5%-D95% ranged between 6.2 +/- 1.0% to 6.7 +/- 1.3%. For rectum, all planning objectives were largely met (e.g. V70Gy = 10.7 +/- 5.5% against an objective of < 25%) similarly for bladder (e.g. D2% = 79.4 +/- 1.2 Gy against an objective of 80.0 Gy). Maximum dose to femurs was D2% = 36.7 +/- 5.4 Gy against an objective of 47 Gy. Monitor Units resulted: MU/Gy = 239 +/- 37. Average beam on time was 1.24 +/- 0.0 minutes. Pre-treatment GAI resulted in 98.1 +/- 1.1%. Clinical data were recorded as PSA at 6 weeks after RT, with median values of 0.4 +/- 0.4 ng/mL. Concerning acute toxicity, no patient showed grade 2-3 rectal toxicity; 5/42 (12%) patients experienced grade 2 dysuria; 18/41 (44%) patients preserved complete or partial erectile function.

Conclusion: RapidArc proved to be a safe, qualitative and advantageous treatment modality for prostate cancer.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Isodose distributions for one example patient for RA treatments for an axial plane, sagittal and coronal views. Doses are shown in colorwash within the interval from 30 to 81 Gy.
Figure 2
Figure 2
Average Dose Volume Histograms for CTV, PTV, Bladder, Rectum, Femurs, Penile Bulb and Healthy Tissue for RA plans. Dashed lines represent inter-patient variability at 1 standard deviation
See this image and copyright information in PMC

References

    1. NICER and FSO Statistics of Cancer Incidence: Switzerland 1983-2006. http://www.ti.ch/tumori
    1. Otto K. Volumetric Modulated Arc Therapy: IMRT in a single arc. Med Phys. 2008;35:310–317. doi: 10.1118/1.2818738. - DOI - PubMed
    1. Clivio A, Fogliata A, Franzetti-Pellanda A, Nicolini G, Vanetti E, Wyttenbach R, Cozzi L. Volumetric-modulated arc radiotherapy for carcinomas of the anal canal: A treatment planning comparison with fixed field IMRT. Radiother Oncol. 2009;92:118–124. doi: 10.1016/j.radonc.2008.12.020. - DOI - PubMed
    1. Cozzi L, Dinshaw KA, Shrivastava SK, Mahantshetty U, Engineer R, Deshpande DD, Jamema SV, Vanetti E, Clivio A, Nicolini G, Fogliata A. A treatment planning study comparing volumetric arc modulation with RapidArc and fixed field IMRT for cervix uteri radiotherapy. Radiother Oncol. 2008;89:180–191. doi: 10.1016/j.radonc.2008.06.013. - DOI - PubMed
    1. Fogliata A, Clivio A, Nicolini G, Vanetti E, Cozzi L. Intensity modulation with photons for benign intracranial tumours: a planning comparison of volumetric single arc, helical arc and fixed gantry techniques. Radiother Oncol. 2008;89:254–262. doi: 10.1016/j.radonc.2008.07.021. - DOI - PubMed

Publication types