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Monte Carlo-Based Dose Calculation in Postprostatectomy Image-Guided Intensity Modulated Radiotherapy: A Pilot Study


Affiliations
1 North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia
2 North Coast Cancer Institute, Lismore, NSW 2480, Australia
 

Step-and-shoot (S&S) intensity-modulated radiotherapy (IMRT) using the XiO treatment planning system(TPS) has been routinely used for patients receiving postprostatectomy radiotherapy (PPRT). After installing the Monaco, a pilot study was undertaken with five patients to compare XiO with Monaco (V2.03) TPS for PPRT with respect to plan quality for S&S as well as volumetricmodulated arc therapy (VMAT). Monaco S&S showed higher mean clinical target volume (CTV) coverage (99.85%) than both XiO S&S (97.98%, P = 0.04) and Monaco VMAT (99.44, P = 0.02). Rectal V60Gy volumes were lower for Monaco S&S compared to XiO (46.36% versus 58.06%, P = 0.001) and Monaco VMAT (46.36% versus 54.66%, P = 0.02). Rectal V60Gy volume was lowest for Monaco S&S and superior to XiO (mean 19.89% versus 31.25%, P = 0.02). Rectal V60Gy volumes were lower for Monaco VMAT compared to XiO (21.09% versus 31.25%, P = 0.02). Other organ-at-risk (OAR) parameters were comparable between TPSs. Compared to XiO S&S, Monaco S&S plans had fewer segments (78.6 versus 116.8 segments, P = 0.02), lower total monitor units (MU) (677.6MU versus 770.7MU, P = 0.01), and shorter beam-on times (5.7 min versus 7.6 min, P = 0.03). This pilot study suggests that Monaco S&S improves CTV coverage, OAR doses, and planning and treatment times for PPRT.
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  • Monte Carlo-Based Dose Calculation in Postprostatectomy Image-Guided Intensity Modulated Radiotherapy: A Pilot Study

Abstract Views: 55  |  PDF Views: 2

Authors

Ashley Rankine
North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia
Kirsty Turnbull
North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia
Stuart Greenham
North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia
Thomas P. Shakespeare
North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia
Justin Westhuyzen
North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia
Andrew Kovendy
North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia
Ben Chua
North Coast Cancer Institute, Coffs Harbour, NSW 2450, Australia
Michael J. McKay
North Coast Cancer Institute, Lismore, NSW 2480, Australia

Abstract


Step-and-shoot (S&S) intensity-modulated radiotherapy (IMRT) using the XiO treatment planning system(TPS) has been routinely used for patients receiving postprostatectomy radiotherapy (PPRT). After installing the Monaco, a pilot study was undertaken with five patients to compare XiO with Monaco (V2.03) TPS for PPRT with respect to plan quality for S&S as well as volumetricmodulated arc therapy (VMAT). Monaco S&S showed higher mean clinical target volume (CTV) coverage (99.85%) than both XiO S&S (97.98%, P = 0.04) and Monaco VMAT (99.44, P = 0.02). Rectal V60Gy volumes were lower for Monaco S&S compared to XiO (46.36% versus 58.06%, P = 0.001) and Monaco VMAT (46.36% versus 54.66%, P = 0.02). Rectal V60Gy volume was lowest for Monaco S&S and superior to XiO (mean 19.89% versus 31.25%, P = 0.02). Rectal V60Gy volumes were lower for Monaco VMAT compared to XiO (21.09% versus 31.25%, P = 0.02). Other organ-at-risk (OAR) parameters were comparable between TPSs. Compared to XiO S&S, Monaco S&S plans had fewer segments (78.6 versus 116.8 segments, P = 0.02), lower total monitor units (MU) (677.6MU versus 770.7MU, P = 0.01), and shorter beam-on times (5.7 min versus 7.6 min, P = 0.03). This pilot study suggests that Monaco S&S improves CTV coverage, OAR doses, and planning and treatment times for PPRT.