title: Maximizing dosimetric benefits of IMRT in the treatment of localized prostate cancer through multicriteria optimization planning.
abstract: We examine the quality of plans created using multicriteria optimization (MCO) treatment planning in intensity-modulated radiation therapy (IMRT) in treatment of localized prostate cancer. Nine random cases of patients receiving IMRT to the prostate were selected. Each case was associated with a clinically approved plan created using Corvus. The cases were replanned using MCO-based planning in RayStation. Dose-volume histogram data from both planning systems were presented to 2 radiation oncologists in a blinded evaluation, and were compared at a number of dose-volume points. Both physicians rated all 9 MCO plans as superior to the clinically approved plans (p<10(-5)). Target coverage was equivalent (p = 0.81). Maximum doses to the prostate and bladder and the V50 and V70 to the anterior rectum were reduced in all MCO plans (p<0.05). Treatment planning time with MCO took approximately 60 minutes per case. MCO-based planning for prostate IMRT is efficient and produces high-quality plans with good target homogeneity and sparing of the anterior rectum, bladder, and femoral heads, without sacrificing target coverage.
authors.affiliation: Harvard Medical School, Boston, MA, USA.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Wala
authors.forename: David
authors.initials: D
authors.lastname: Craft
authors.forename: Jon
authors.initials: J
authors.lastname: Paly
authors.forename: Anthony
authors.initials: A
authors.lastname: Zietman
authors.forename: Jason
authors.initials: J
authors.lastname: Efstathiou
mesh_terms: D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*
keywords: IMRT; Multicriteria optimization; Prostate