Definition of fields margins for the optimized 2D radiotherapy of prostate carcinoma

Buwenge,Milly; Perrone,Mariangela; Siepe,Giambattista; Capocaccia,Ilaria; Woldemariam,Aynalem  Abraha; Wondemagegnhu,Tigeneh; Uddin,Kamal  A.F.M.; Sumon,Mostafa  A.; Galofaro,Elena; Macchia,Gabriella; Deodato,Francesco; Cilla,Savino; Morganti,Alessio  G.

doi:10.3892/mco.2019.1855

Definition of fields margins for the optimized 2D radiotherapy of prostate carcinoma

Authors:
- Milly Buwenge
- Mariangela Perrone
- Giambattista Siepe
- Ilaria Capocaccia
- Aynalem Abraha Woldemariam
- Tigeneh Wondemagegnhu
- Kamal A.F.M. Uddin
- Mostafa A. Sumon
- Elena Galofaro
- Gabriella Macchia
- Francesco Deodato
- Savino Cilla
- Alessio G. Morganti
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Affiliations: Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine‑DIMES, University of Bologna, S. Orsola‑Malpighi Hospital, I‑40138 Bologna, Italy, Radiotherapy Unit, Fondazione di Ricerca e Cura ‘Giovanni Paolo II’, Catholic University of Sacred Heart, I‑86100 Campobasso, Italy, Department of Radiation Oncology, Black Lion Hospital, 9086 Addis Ababa, Ethiopia, Radiation Oncology Department, United Hospital Limited, Gulshan, Dhaka 1212, Bangladesh, Medical Physic Unit, Fondazione di Ricerca e Cura ‘Giovanni Paolo II’, Catholic University of Sacred Heart, I‑86100 Campobasso, Italy
Published online on: May 8, 2019 https://doi.org/10.3892/mco.2019.1855
Pages: 37-42
Copyright: © Buwenge et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Prostate cancer (PCa) is one of the most common malignancies in men both in western and developing countries. Radiotherapy (RT) is an important therapeutic option. New technologies (including 3D, intensity modulated RT, image‑guided RT and, volumetric modulated arc therapy) have been introduced in the last few decades with progressive improvement of clinical outcomes. However, in many developing countries, the only treatment option is the traditional two‑dimensional (2D) technique based on standard simulation. The guidelines for 2D field definition are still based on expert's opinions. The aim of the present study was to propose new practical guidelines for 2D fields definition based on 3D simulation in PCa. A total of 20 patients were enrolled. Computed tomography‑simulation and pelvic magnetic resonance images were merged to define the prostate volumes. Clinical Target Volume (CTV) was defined using the European Organisation for Research and Treatment of Cancer guidelines in consideration of the four risk categories: Low, intermediate, and high risk with or without seminal vesicles involvement, respectively. Planning Target Volume (PTV) was defined by adding 10 mm to the CTV. For each category, two treatment plans were calculated using a cobalt source or 10 MV photons. Progressive optimization was achieved by evaluating 3D dose distribution. Finally, the optimal distances between field margins and radiological landmarks (bones and rectum with contrast medium) were defined. The results were reported in tabular form. Both field margins (PTV D98% >95%) needed to adequately irradiate all patients and to achieve a similar result in 95% of the enrolled patients are reported. Using a group of patients with PCa and based on a 3D planning analysis, we propose new practical guidelines for PCa 2D‑RT based on current criteria for risk category and CTV, and PTV definition.

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