Selective sparing of bladder and rectum sub-regions in radiotherapy of prostate cancer combining knowledge-based automatic planning and multicriteria optimization

dc.affiliation.dptoUC3M. Departamento de Bioingenieríaes
dc.affiliation.grupoinvUC3M. Grupo de Investigación: Biomedical Imaging and Instrumentation Groupes
dc.contributor.authorAlborghetti, Lisa
dc.contributor.authorCastriconi, Roberta
dc.contributor.authorSosa Marrero, Carlos
dc.contributor.authorTudda, Alessia
dc.contributor.authorUbeira-Gabellini, Maria Guiulia
dc.contributor.authorBroggi, Sara
dc.contributor.authorPascau González-Garzón, Javier
dc.contributor.authorCubero Gutierrez, Lucia
dc.contributor.authorCozzarini, Cesare
dc.contributor.authorCrevoisier, Renaud De
dc.contributor.authorRancati, Tiziana
dc.contributor.authorAcosta, Oscar
dc.contributor.authorFiorino, Claudio
dc.description.abstractBackground and Purpose: The association between dose to selected bladder and rectum symptom-related sub- regions (SRS) and late toxicity after prostate cancer radiotherapy has been evidenced by voxel-wise analyses. The aim of the current study was to explore the feasibility of combining knowledge-based (KB) and multi-criteria optimization (MCO) to spare SRSs without compromising planning target volume (PTV) dose delivery, including pelvic-node irradiation. Materials and Methods: Forty-five previously treated patients (74.2 Gy/28fr) were selected and SRSs (in the bladder, associated with late dysuria/hematuria/retention; in the rectum, associated with bleeding) were generated using deformable registration. A KB model was used to obtain clinically suitable plans (KB-plan). KB- plans were further optimized using MCO, aiming to reduce dose to the SRSs while safeguarding target dose coverage, homogeneity and avoiding worsening dose volume histograms of the whole bladder, rectum and other organs at risk. The resulting MCO-generated plans were examined to identify the best-compromise plan (KB + MCO-plan). Results: The mean SRS dose decreased in almost all patients for each SRS. D1% also decreased in the large majority, less frequently for dysuria/bleeding SRS. Mean differences were statistically significant (p < 0.05) and ranged between 1.3 and 2.2 Gy with maximum reduction of mean dose up to 3&#8211;5 Gy for the four SRSs. The better sparing of SRSs was obtained without compromising PTVs coverage. Conclusions: Selectively sparing SRSs without compromising PTV coverage is feasible and has the potential to reduce toxicities in prostate cancer radiotherapy. Further investigation to better quantify the expected risk reduction of late toxicities is warranted.en
dc.description.sponsorshipThis work has been supported by Fondazione Regionale per la Ricerca Biomedica, project nr. 110 - JTC PerPlanRT ERA PerMed, GA 779282.en
dc.identifier.bibliographicCitationAlborghetti, L., Castriconi, R., Sosa Marrero, C., Tudda, A., Ubeira-Gabellini, M.G., Broggi, S., Pascau, J., Cubero, L., Cozzarini, C., Crevoisier, R. de, Rancati, T., Acosta, O., Fiorino, C.(2023). Selective sparing of bladder and rectum sub-regions in radiotherapy of prostate cancer combining knowledge-based automatic planning and multicriteria optimization.Physics and Imaging in Radiation Oncology 28 (2023) 100488, (10p.).
dc.identifier.publicationtitlePhysics and Imaging in Radiation Oncologyen
dc.rights2023 The Author(s). Published by Elsevier B.V. on behalf of European Society of Radiotherapy & Oncology.en
dc.rightsThis is an open access article under the CC BY-NC-ND license.en
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 España*
dc.rights.accessRightsopen accessen
dc.subject.ecienciaBiología y Biomedicinaes
dc.subject.otherProstate canceren
dc.subject.otherAutomated planningen
dc.subject.otherDose-outcome correlationen
dc.subject.otherMulti-criteria optimizationen
dc.titleSelective sparing of bladder and rectum sub-regions in radiotherapy of prostate cancer combining knowledge-based automatic planning and multicriteria optimizationen
dc.typeresearch articleen
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