title: Treatment planning evaluation of non-coplanar techniques for conformal radiotherapy of the prostate.
abstract: OBJECTIVE
  To evaluate the benefit of using non-coplanar treatment plans for irradiation of two different clinical treatment volumes: prostate only (PO) and the prostate plus seminal vesicles (PSV).
  
  
  METHODS
  An inverse planning algorithm was used to produce three-field, four-field, five-field and six-field non-coplanar treatment plans without intensity-modulation in ten patients. These were compared against a three-field coplanar plan. A dose of 74 Gy was prescribed to the isocentre. Plans were compared using the minimum dose to the planning target volume (PTV), maximum dose to the small bowel, and irradiated volumes of rectum, bladder and femoral head. Biological indices were also evaluated.
  
  
  RESULTS
  For the PO group, volume of rectum irradiated to 60 Gy (V(60)) was 22.5+/-3.7% for the coplanar plan, and 21.5+/-5.3% for the five-field non-coplanar plan, which was the most beneficial (p=0.3). For the PSV group, the five-field non-coplanar plan was again the most beneficial. Rectal V(60) was in this case reduced from 41.5+/-10.4% for the coplanar plan to 35.2+/-9.3% for the non-coplanar plan (p=0.02).
  
  
  CONCLUSIONS
  The use of non-coplanar beams in conformal prostate radiotherapy provides a small increase in rectal sparing, more significantly with PSV volumes than for PO volumes.
authors.affiliation: Joint Department of Physics, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey, UK. james.bedford@icr.uk
authors.forename: James L
authors.initials: JL
authors.lastname: Bedford
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Henrys
authors.forename: David P
authors.initials: DP
authors.lastname: Dearnaley
authors.forename: Vincent S
authors.initials: VS
authors.lastname: Khoo
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies