Surveillance on interfacility differences in dose-prescription policy of intensity-modulated radiation therapy plans for prostate cancer.

Takashi Mizowaki, Kazuo Hatano, Masahiro Hiraoka

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    7 Scopus citations

    Abstract

    Intensity-modulated radiation therapy (IMRT) has recently become popular in Japan. Prostate cancer is indisputably one of the main targets of IMRT. However, the current status and interfacility differences in dose-prescription policies for prostate IMRT are unknown. Therefore, a nationwide survey of 43 institutions that had implemented prostate IMRT was conducted by sending a questionnaire regarding the above-mentioned issues. Thirty-three institutions (77%) had responded to the questionnaire by the end of October 2010. A total of 5245 patients with localized prostate cancer had been treated with IMRT by the end of 2009. Regular multileaf collimator-based techniques were the most common beam delivery method. Dose-prescription policies were divided into four major categories: isocenter-based (@isocenter), dose delivered to 95% of the planning target volume (PTV) (D95)-based (D95@PTV), mean dose to the PTV-based (Mean@PTV), and mean dose to the clinical target volume (CTV)-based (@CTV). The mean doses of the CTV and PTV, and the volume of the PTV receiving 95% of the dose (V95) were significantly higher with the D95@PTV policy than with the other prescription policies. Low-dose areas and hot spots were observed within the PTV in plans with @isocenter and @CTV policies. In conclusion, there are currently considerable differences among institutions in Japan regarding target doses for prostate IMRT. The D95@PTV prescription policy resulted in significant dose escalation compared with the other policies. These differences should be taken into consideration when interpreting treatment outcomes and creating multi-institutional protocols in the future.

    Original languageEnglish (US)
    Pages (from-to)608-614
    Number of pages7
    JournalJournal of radiation research
    Volume53
    Issue number4
    DOIs
    StatePublished - Jul 2012

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    ASJC Scopus subject areas

    • Radiation
    • Radiology Nuclear Medicine and imaging
    • Health, Toxicology and Mutagenesis

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