Feasibility of upright carbon ion radiotherapy for prostate cancer: Dosimetric comparison between supine and upright postures
Abstract
BACKGROUND: Carbon ion radiotherapy (CIRT) in the upright posture is a treatment technique which delivers carbon ion beams from a fixed direction to patients who sit or stand on a rotating chair. Although various potential advantages of the upright positioning have been discussed, feasibility of upright CIRT for prostate cancer has not been quantitatively evaluated.
PURPOSE: This study demonstrated prostate cancer CIRT in the upright posture and evaluated its feasibility by comparing anatomy and dosimetric metrics between the supine and upright postures.
METHODS: A total of 12 pairs of computed tomography (CT) images of asymptomatic volunteers in the supine and upright postures were retrospectively analyzed. Based on a clinical treatment protocol, clinical target volume (CTV) was defined as being a prostate gland and proximal seminal vesicle. Other target and organ-at-risk (OAR) contours within a planning volume were also delineated. A CIRT plan was calculated for each CT volume with the same dose prescription and evaluation criteria. The delineated contour volumes, 16 dosimetric metrics, dose-volume histograms (DVHs) of CTV and OARs, and robustness against setup and range uncertainties were compared between the supine and upright postures.
RESULTS: No significant differences in the contour volumes were found between the two postures (p > 0.05). The CTV and rectum contour volumes were 34.30 ± 7.76 and 36.35 ± 13.53 cm3 for the supine posture and 35.89 ± 7.37 and 32.96 ± 8.08…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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