Planning study: prone versus supine position for stereotactic body radiotherapy in prostate by CyberKnife

Author:

Kon Mitsuhiro12,Okamoto Hiroyuki1,Nakamura Satoshi1,Iijima Kotaro1,Chiba Takahito1,Takemori Mihiro1,Nakayama Hiroki1,Nakaichi Tetsu1,Mikasa Shohei1,Fujii Kyohei1,Urago Yuka1,Ishikawa Masayori3,Sofue Toshimitsu2,Katsuta Shoichi2,Inaba Koji4,Igaki Hiroshi4,Aso Tomohiko2

Affiliation:

1. Radiation Safety and Quality Assurance Division, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku Tokyo, 104-0045 , Japan

2. Department of Radiological Technology, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku Tokyo, 104-0045 , Japan

3. Faculty of Health Sciences, Hokkaido University , North12, West5, Kita-ku, Sapporo, Hokkaido 060-0812 , Japan

4. Department of Radiation Oncology, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku Tokyo, 104-0045 , Japan

Abstract

Abstract This study aimed to clarify the differences in radiotherapy dose characteristics and delivery efficiency between the supine and prone positions in patients with prostate cancer using the CyberKnife. The planning computed tomography (CT) and delineations of the prone position were obtained by rotating the supine CT images with delineations of 180° using image processing software. The optimization parameters for planning target volume (PTV) and organs at risk (OARs) were based on the prone position. The optimization parameters determined for the prone position were applied to the supine position for optimization and dose calculation. The dosimetric characteristics of the PTV and OARs, and delivery efficiency were compared between the two different patient positions. The plans in the prone position resulted in better PTV conformity index (nCI), rectum V90%, V80%, V75%, V50% and bladder V50%. A significant difference was observed in treatment time and depth along the central axis (dCAX) between the two plans. The mean treatment time per fraction and dCAX for the supine and prone positions were 20.9 ± 1.7 min versus 19.8 ± 1.3 min (P = 0.019) and 151.1 ± 33.6 mm versus 233.2 ± 8.8 mm (P < 0.001), respectively. In this study the prone position was found to improve dosimetric characteristics and delivery efficiency compared with the supine position during prostate cancer treatment with the CyberKnife.

Funder

Ministry of Education, Culture, Sports, Science and Technology

National Cancer Center Research and Development Fund

Publisher

Oxford University Press (OUP)

Subject

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

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