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Secondary Malignancies From Prostate Cancer Radiation Treatment: A Risk Analysis of the Influence of Target Margins and Fractionation Patterns

Dasu, Alexandru; Toma-Dasu, Iuliana; Franzen, Lars; Widmark, Anders and Nilsson, Per LU (2011) In International Journal of Radiation Oncology, Biology, Physics 79(3). p.738-746
Abstract
Purpose: This study explores the implications for cancer induction of treatment details such as fractionation, planning target volume (PTV) definition, and interpatient variations, which are relevant for the radiation treatment of prostate carcinomas. Methods and Materials: Treatment planning data from 100 patients have been analyzed with a risk model based on the United Nations Scientific Committee on the Effects of Atomic Radiation competition model. The risk model can account for dose heterogeneity and fractionation effects characteristic for modern radiotherapy. Biologically relevant parameters from clinical and experimental data have been used with the model. Results: The results suggested that changes in prescribed dose could lead to... (More)
Purpose: This study explores the implications for cancer induction of treatment details such as fractionation, planning target volume (PTV) definition, and interpatient variations, which are relevant for the radiation treatment of prostate carcinomas. Methods and Materials: Treatment planning data from 100 patients have been analyzed with a risk model based on the United Nations Scientific Committee on the Effects of Atomic Radiation competition model. The risk model can account for dose heterogeneity and fractionation effects characteristic for modern radiotherapy. Biologically relevant parameters from clinical and experimental data have been used with the model. Results: The results suggested that changes in prescribed dose could lead to a modification of the risks for individual organs surrounding the clinical target volume (CTV) but that the total risk appears to be less affected by changes in the target dose. Larger differences are observed for modifications of the margins between the CTV and the PTV because these have direct impact onto the dose level and dose heterogeneity in the healthy tissues surrounding the CTV. Interpatient anatomic variations also have to be taken into consideration for studies of the risk for cancer induction from radiotherapy. Conclusions: The results have shown the complex interplay between the risk for secondary malignancies, the details of the treatment delivery, and the patient heterogeneity that may influence comparisons between the long-term effects of various treatment techniques. Nevertheless, absolute risk levels seem very small and comparable to mortality risks from surgical interventions, thus supporting the robustness of radiation therapy as a successful treatment modality for prostate carcinomas. (C) 2011 Elsevier Inc. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Prostate cancer, Carcinogenesis, Radiation treatment, DVH, Fractionation
in
International Journal of Radiation Oncology, Biology, Physics
volume
79
issue
3
pages
738 - 746
publisher
Elsevier
external identifiers
  • wos:000287382400014
  • scopus:79551501700
ISSN
0360-3016
DOI
10.1016/j.ijrobp.2009.12.004
language
English
LU publication?
yes
id
15275397-b88c-4a9c-8750-329ce4d6e2e0 (old id 1878017)
date added to LUP
2011-04-01 09:42:57
date last changed
2017-01-01 04:06:22
@article{15275397-b88c-4a9c-8750-329ce4d6e2e0,
  abstract     = {Purpose: This study explores the implications for cancer induction of treatment details such as fractionation, planning target volume (PTV) definition, and interpatient variations, which are relevant for the radiation treatment of prostate carcinomas. Methods and Materials: Treatment planning data from 100 patients have been analyzed with a risk model based on the United Nations Scientific Committee on the Effects of Atomic Radiation competition model. The risk model can account for dose heterogeneity and fractionation effects characteristic for modern radiotherapy. Biologically relevant parameters from clinical and experimental data have been used with the model. Results: The results suggested that changes in prescribed dose could lead to a modification of the risks for individual organs surrounding the clinical target volume (CTV) but that the total risk appears to be less affected by changes in the target dose. Larger differences are observed for modifications of the margins between the CTV and the PTV because these have direct impact onto the dose level and dose heterogeneity in the healthy tissues surrounding the CTV. Interpatient anatomic variations also have to be taken into consideration for studies of the risk for cancer induction from radiotherapy. Conclusions: The results have shown the complex interplay between the risk for secondary malignancies, the details of the treatment delivery, and the patient heterogeneity that may influence comparisons between the long-term effects of various treatment techniques. Nevertheless, absolute risk levels seem very small and comparable to mortality risks from surgical interventions, thus supporting the robustness of radiation therapy as a successful treatment modality for prostate carcinomas. (C) 2011 Elsevier Inc.},
  author       = {Dasu, Alexandru and Toma-Dasu, Iuliana and Franzen, Lars and Widmark, Anders and Nilsson, Per},
  issn         = {0360-3016},
  keyword      = {Prostate cancer,Carcinogenesis,Radiation treatment,DVH,Fractionation},
  language     = {eng},
  number       = {3},
  pages        = {738--746},
  publisher    = {Elsevier},
  series       = {International Journal of Radiation Oncology, Biology, Physics},
  title        = {Secondary Malignancies From Prostate Cancer Radiation Treatment: A Risk Analysis of the Influence of Target Margins and Fractionation Patterns},
  url          = {http://dx.doi.org/10.1016/j.ijrobp.2009.12.004},
  volume       = {79},
  year         = {2011},
}