title: Integral dose: Comparison between four techniques for prostate radiotherapy.
abstract: OBJECTIVE
  Comparisons of integral dose delivered to the treatment planning volume and to the whole patient body during stereotactic, helical and intensity modulated radiotherapy of prostate.
  
  
  BACKGROUND
  Multifield techniques produce large volumes of low dose inside the patient body. Delivered dose could be the result of the cytotoxic injuries of the cells even away from the treatment field. We calculated the total dose absorbed in the patient body for four radiotherapy techniques to investigate whether some methods have a potential to reduce the exposure to the patient.
  
  
  METHODS
  We analyzed CyberKnife plans for 10 patients with localized prostate cancer. Five alternative plans for each patient were calculated with the VMAT, IMRT and TomoTherapy techniques. Alternative dose distributions were calculated to achieve the same coverage for PTV. Integral Dose formula was used to calculate the total dose delivered to the PTV and whole patient body.
  
  
  RESULTS
  Analysis showed that the same amount of dose was deposited to the treated volume despite different methods of treatment delivery. The mean values of total dose delivered to the whole patient body differed significantly for each treatment technique. The highest integral dose in the patient's body was at the TomoTherapy and CyberKnife treatment session. VMAT was characterized by the lowest integral dose deposited in the patient body.
  
  
  CONCLUSIONS
  The highest total dose absorbed in normal tissue was observed with the use of a robotic radiosurgery system and TomoTherapy. These results demonstrate that the exposure of healthy tissue is a dosimetric factor which differentiates the dose delivery methods.
authors: MSC Memorial Cancer Center and Institute of Oncology Gliwice Branch, Department of Radiotherapy and Brachytherapy Planning, ul. Wybrzeża Armii Krajowej 15, 44-101 Gliwice, Poland.
authors: Krzysztof
authors: K
authors: Ślosarek
authors: MSC Memorial Cancer Center and Institute of Oncology Gliwice Branch, Radiotherapy Department, ul. Wybrzeża Armii Krajowej 15, 44-101 Gliwice, Poland.
authors: Wojciech
authors: W
authors: Osewski
authors: MSC Memorial Cancer Center and Institute of Oncology Gliwice Branch, Department of Radiotherapy and Brachytherapy Planning, ul. Wybrzeża Armii Krajowej 15, 44-101 Gliwice, Poland.
authors: Aleksandra
authors: A
authors: Grządziel
authors: MSC Memorial Cancer Center and Institute of Oncology Gliwice Branch, Department of Radiotherapy and Brachytherapy Planning, ul. Wybrzeża Armii Krajowej 15, 44-101 Gliwice, Poland.
authors: Michał
authors: M
authors: Radwan
authors: MSC Memorial Cancer Center and Institute of Oncology Gliwice Branch, Department of Radiotherapy and Brachytherapy Planning, ul. Wybrzeża Armii Krajowej 15, 44-101 Gliwice, Poland.
authors: Łukasz
authors: Ł
authors: Dolla
authors: MSC Memorial Cancer Center and Institute of Oncology Gliwice Branch, Department of Radiotherapy and Brachytherapy Planning, ul. Wybrzeża Armii Krajowej 15, 44-101 Gliwice, Poland.
authors: Marta
authors: M
authors: Szlag
authors: MSC Memorial Cancer Center and Institute of Oncology Gliwice Branch, Department of Radiotherapy and Brachytherapy Planning, ul. Wybrzeża Armii Krajowej 15, 44-101 Gliwice, Poland.
authors: Małgorzata
authors: M
authors: Stąpór-Fudzińska
keywords: CyberKnife; Integral dose; Prostate cancer; TomoTherapy; VMAT