title: SBRT for prostate cancer: Challenges and features from a physicist prospective.
abstract: Emerging data are showing the safety and the efficacy of Stereotactic Body Radiation Therapy (SBRT) in prostate cancer management. In this context, the medical physicists are regularly involved to review the appropriateness of the adopted technology and to proactively study new solutions. From the physics point of view there are two major challenges in prostate SBRT: (1) mitigation of geometrical uncertainty and (2) generation of highly conformal dose distributions that maximally spare the OARs. Geometrical uncertainties have to be limited as much as possible in order to avoid the use of large PTV margins. Furthermore, advanced planning and delivery techniques are needed to generate maximally conformal dose distributions. In this non-systematic review the technology and the physics aspects of SBRT for prostate cancer were analyzed. In details, the aims were: (i) to describe the rationale of reducing the number of fractions (i.e. increasing the dose per fraction), (ii) to analyze the features to be accounted for performing an extreme hypo-fractionation scheme (>6-7Gy), and (iii) to describe technological solutions for treating in a safe way. The analysis of outcomes, toxicities, and other clinical aspects are not object of the present evaluation.
authors.affiliation: Humanitas Clinical and Research Hospital, Rozzano, Milano, Italy. Electronic address: pietro.mancosu@humanitas.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Mancosu
authors.affiliation: Azienda Ospedaliera Universitaria Federico II Napoli, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Clemente
authors.affiliation: Istituto Nazionale Tumori Regina Elena, Roma, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Landoni
authors.affiliation: Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Ruggero
authors.initials: R
authors.lastname: Ruggieri
authors.affiliation: Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Alongi
authors.affiliation: Humanitas Clinical and Research Hospital, Rozzano, Milano, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Milano, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Scorsetti
authors.affiliation: Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Stasi
mesh_terms: D019583:Dose Fractionation, Radiation; D006283:Health Physics; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D016634:Radiosurgery / Q000379:methods*
keywords: Medical physics; Prostate; SABR; SBRT