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      The Impact of Tissue Inhomogeneity Corrections in the Treatment of Prostate Cancer with Intensity-Modulated Radiation Therapy = 전립선암의 세기조절 방사선 치료시 밀도보정의 효과

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      https://www.riss.kr/link?id=A100687427

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      다국어 초록 (Multilingual Abstract)

      Purpose: To investigate the effects of tissue inhomogeneity corrections on the dose delivered to prostate cancer patients treated with Intensity-Modulated Radiation Therapy (IMRT). Methods and Materials: For five prostate cancer patients, IMRT treatment plans were generated using 6 MV or 10 MV X-rays. In each plan, seven equally spaced ports of photon beams were directed to the isocenter, neglecting the tissue heterogeneity in the body. The dose at the isocenter, mean dose, maximum dose, minimum dose and volume that received more than 95% of the isocenter dose in the planning target volume ( $V_{p>95%}$) were measured. The maximum doses to the rectum and the bladder, and the volumes that received more than 50, 75 and 90% of the prescribed dose were measured. Treatment plans were then recomputed using tissue inhomogeneity correction maintaining the intensity profiles and monitor units of each port. The prescription point dose and other dosimetric parameters were remeasured. Results: The inhomogeneity correction reduced the prescription point dose by an average 4.9 and 4.0% with 6 and 10 MV X-rays, respectively. The average reductions of the $V_{p>95%}$ were 0.8 and 0.9% with the 6 and 10 MV X-rays, respectively. The mean doses in the PTV were reduced by an average of 4.2 and 3.4% with the 6 and 10 MV X-rays, respectively. The irradiated volume parameters in the rectum and bladder were less decreased; less than 2.1 % (1.2%) of the reduction in the rectum (bladder). The average reductions in the mean dose were 1.0 and 0.5% in the rectum and bladder, respectively. Conclusions: Neglect of tissue inhomogeneity in the IMRT treatment of prostate cancer gives rise to a notable overestimation of the dose delivered to the target, whereas the impact of tissue inhomogeneity correction to the surrounding critical organs is less significant.
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      Purpose: To investigate the effects of tissue inhomogeneity corrections on the dose delivered to prostate cancer patients treated with Intensity-Modulated Radiation Therapy (IMRT). Methods and Materials: For five prostate cancer patients, IMRT treatme...

      Purpose: To investigate the effects of tissue inhomogeneity corrections on the dose delivered to prostate cancer patients treated with Intensity-Modulated Radiation Therapy (IMRT). Methods and Materials: For five prostate cancer patients, IMRT treatment plans were generated using 6 MV or 10 MV X-rays. In each plan, seven equally spaced ports of photon beams were directed to the isocenter, neglecting the tissue heterogeneity in the body. The dose at the isocenter, mean dose, maximum dose, minimum dose and volume that received more than 95% of the isocenter dose in the planning target volume ( $V_{p>95%}$) were measured. The maximum doses to the rectum and the bladder, and the volumes that received more than 50, 75 and 90% of the prescribed dose were measured. Treatment plans were then recomputed using tissue inhomogeneity correction maintaining the intensity profiles and monitor units of each port. The prescription point dose and other dosimetric parameters were remeasured. Results: The inhomogeneity correction reduced the prescription point dose by an average 4.9 and 4.0% with 6 and 10 MV X-rays, respectively. The average reductions of the $V_{p>95%}$ were 0.8 and 0.9% with the 6 and 10 MV X-rays, respectively. The mean doses in the PTV were reduced by an average of 4.2 and 3.4% with the 6 and 10 MV X-rays, respectively. The irradiated volume parameters in the rectum and bladder were less decreased; less than 2.1 % (1.2%) of the reduction in the rectum (bladder). The average reductions in the mean dose were 1.0 and 0.5% in the rectum and bladder, respectively. Conclusions: Neglect of tissue inhomogeneity in the IMRT treatment of prostate cancer gives rise to a notable overestimation of the dose delivered to the target, whereas the impact of tissue inhomogeneity correction to the surrounding critical organs is less significant.

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      참고문헌 (Reference)

      1 "Tissue heterogeneity effects in treatment plan optimization. Int J Radiat Oncol Biol Phys 30" 699-706, 1994

      2 "Three-dimensional photon dose distributions with and without lung corrections for tangential breast intact treatments. Int J Radiat Oncol Biol Phys 17" 1327-1335, 1989

      3 "Study of lung density corrections in a clinical trial" 41 : 787-08 794, 1998

      4 "Results for the M.D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 53" 1097-1105, 2002

      5 "Relationships between DVHs and late rectal bleeding after radiotherapy for prostate cancer analysis of a large group of patients pooled from three institutions. Radiother Oncol 64" 64 : 1-12, 2002

      6 "Prostate and pelvic node irradiation using Helios and a 120-leaf multileaf collimator" 273-284, 2002

      7 "Preliminary results of a randomized radiotherapy dose-escalation study comparing 70 Gy with 78 Gy for prostate cancer. J Clin Oncol 18" 3904-3911, 2000

      8 "Potential improvements in the therapeutic ratio of prostate cancer irradiation dose escalation of pathologically identified tumor nodules using intensity modulated radiotherapy. Br J Radiol 75" 75 : 151-161, 2002

      9 "Photon Treatment Planning Collaborative Working Group. Role of inhomogeneity correction in three-dimensional photon treatment planning. Int J Radiat Oncol Biol Phys 21" 59-69, 1991

      10 "On the impact of tissue inhomogeneity corrections in clinical thoracic radiation therapy. Int J Radiat Oncol Biol Phys 21" 1257-1267, 1991

      1 "Tissue heterogeneity effects in treatment plan optimization. Int J Radiat Oncol Biol Phys 30" 699-706, 1994

      2 "Three-dimensional photon dose distributions with and without lung corrections for tangential breast intact treatments. Int J Radiat Oncol Biol Phys 17" 1327-1335, 1989

      3 "Study of lung density corrections in a clinical trial" 41 : 787-08 794, 1998

      4 "Results for the M.D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 53" 1097-1105, 2002

      5 "Relationships between DVHs and late rectal bleeding after radiotherapy for prostate cancer analysis of a large group of patients pooled from three institutions. Radiother Oncol 64" 64 : 1-12, 2002

      6 "Prostate and pelvic node irradiation using Helios and a 120-leaf multileaf collimator" 273-284, 2002

      7 "Preliminary results of a randomized radiotherapy dose-escalation study comparing 70 Gy with 78 Gy for prostate cancer. J Clin Oncol 18" 3904-3911, 2000

      8 "Potential improvements in the therapeutic ratio of prostate cancer irradiation dose escalation of pathologically identified tumor nodules using intensity modulated radiotherapy. Br J Radiol 75" 75 : 151-161, 2002

      9 "Photon Treatment Planning Collaborative Working Group. Role of inhomogeneity correction in three-dimensional photon treatment planning. Int J Radiat Oncol Biol Phys 21" 59-69, 1991

      10 "On the impact of tissue inhomogeneity corrections in clinical thoracic radiation therapy. Int J Radiat Oncol Biol Phys 21" 1257-1267, 1991

      11 "Late rectal bleeding after conformal radiotherapy of prostate cancer" 49 : 685-698, 2001

      12 "Is correction for lung density in radiotherapy treatment planning necessary? Int J Radiat Oncol Biol Phys 13" 273-278, 1987

      13 "Intensity-modulated radiation therapy for prostate cancer." 229-237, 2002

      14 "Intensity-Modulated Radiation Therapy for prostate cancer with the use of a rectal balloon for prostate immobilization" 49 : 705-712, 2001

      15 "Implications of lung corrections for dose specification in radiotherapy. Int J Radiat Oncol Biol Phys 11" 621-625, 1985

      16 "Impact of tissue heterogeneities on monitor units calculation and ICRU dose point Analysis of 30cases of prostate cancer treated with 18-MV photons after three-dimensional planning. Int J Radiat Oncol Biol Phys 48" 48 : 529-534, 2000

      17 "Impact of CT information on the treatment planning for lung tumors. Med Dosim 14" 9-15, 1989

      18 "High-dose intensity modulated radiation therapy for prostate cancer early toxicity and biochemical outcome in 772 patients. Int J Radiat Oncol Biol Phys 53" 53 : 1111-1116, 2002

      19 "Generation of photon energy deposition kernels using the EGS Monte Carlo code. Phys Med Biol 33" 1-20, 1988

      20 "Forward or inversely planned segmental multileaf collimator IMRT and sequential tomotherapy to treat multiple dominant intraprostatic lesions of prostate cancer to 90 Gy. Int J Radiat Oncol Biol Phys 51" 51 : 244-254, 2001

      21 "External beam radiotherapy dose response characteristics of 1127 men with prostate cancer treated in the PSA era. Int J Radiat Oncol Biol Phys 48" 48 : 507-512, 2000

      22 "Effect of low-density lateral interfaces on soft-tissue doses. Int J Radiat Oncol Biol Phys 37" 37 : 475-482, 1997

      23 "Dose/volume relationship of late rectal bleeding after external beam radiotherapy for localized prostate cancer absolute or relative rectal volume? Cancer J 8" 62-66, 2002

      24 "Dose-volume relationship for acute side effects during high dose conformal radiotherapy for prostate cancer. Radiother Oncol 64" 209-214, 2002

      25 "Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer. Int J Radiat Oncol Biol Phys 41" 491-500, 1998

      26 "Dose escalation with 3-D conformal treatment" 501-510, 1998

      27 "Complications from radiotherapy dose escalation in prostate cancer Preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys 48" 635-642, 2000

      28 "Collapsed cone convolution of radiant energy for photon dose calculation in heterogeneous media. Med Phys 16" 577-592, 1989

      29 "A volumetric study of measurements and calculations of lung density corrections for 6 and 18 MV photons. Int J Radiat Oncol Biol Phys 37" 1163-1170, 1997

      30 "A convolution method of calculating dose for 15-MV x rays. Med Phys 12" 188-1961985

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