Template-based Intensity-Modulated Radiation Therapy: A Cost-effective Intensity-Modulated Radiation Therapy Planning Procedure for Prostate Cancer

Fred Cao; Ramani Ramaseshan; Nancy Cooper; Craig A Elith; Nimet Nuraney; Peter Steiner; Alex Agranovich; Winkle Kwan; Mitchell Liu; Milton Po; Anand Karvat

doi:10.1016/j.jmir.2015.04.013

Template-based Intensity-Modulated Radiation Therapy: A Cost-effective Intensity-Modulated Radiation Therapy Planning Procedure for Prostate Cancer

J Med Imaging Radiat Sci. 2015 Sep;46(3):325-330. doi: 10.1016/j.jmir.2015.04.013. Epub 2015 Jul 4.

Authors

Affiliations

¹ British Columbia Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada. Electronic address: fcao@bccancer.bc.ca.
² British Columbia Cancer Agency-Abbotsford Centre, Abbotsford, British Columbia, Canada.
³ British Columbia Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada.
⁴ British Columbia Cancer Agency-Vancouver Centre, Vancouver, British Columbia, Canada.

PMID: 31052140
DOI: 10.1016/j.jmir.2015.04.013

Abstract

Introduction: Intensity-modulated radiation therapy (IMRT) has been widely accepted for the treatment of prostate cancer. In comparison with traditional three-dimensional conformal radiation therapy (3D-CRT), it improves local control while minimizing side effects. However, IMRT comes at a significantly higher cost. In this report, we describe the development of template-based IMRT (TB-IMRT) planning for prostate cancer that does not require additional resources above 3D-CRT.

Methods: Twenty patients previously treated using 3D-CRT were retrospectively planned using the TB-IMRT planning technique. Planning target volume coverage, dose to organs at risk, and resource usage were compared between 3D-CRT and TB-IMRT techniques.

Results: All 3D-CRT and TB-IMRT plans met the planning guidelines. TB-IMRT compared better than 3D-CRT in terms of the homogeneity index (0.039 ± 0.007 vs. 0.052 ± 0.008) and conformity index (0.866 ± 0.024 vs. 0.752 ± 0.054). TB-IMRT also provided better sparing of organs at risk. Planning times were significantly less for TB-IMRT (average 13.43 ± 2.18 minutes) compared with conventional plans (45.4 ± 17.0 minutes). Times required for patient-specific quality assurance were similar between TB-IMRT and 3D-CRT.

Conclusions: The TB-IMRT technique for prostate allows for all the potential benefits of IMRT without any additional resources above conventional 3D-CRT.

Keywords: 3D-CRT; Template based IMRT; prostate cancer.