Conversion and validation of rectal constraints for prostate carcinoma receiving hypofractionated carbon-ion radiotherapy with a local effect model

Weiwei Wang; Ping Li; Yinxiangzi Sheng; Zhijie Huang; Jingfang Zhao; Zhengshan Hong; Kambiz Shahnazi; Guo-Liang Jiang; Qing Zhang

doi:10.1186/s13014-021-01801-w

Radiation Oncology (Apr 2021)

Conversion and validation of rectal constraints for prostate carcinoma receiving hypofractionated carbon-ion radiotherapy with a local effect model

Weiwei Wang,
Ping Li,
Yinxiangzi Sheng,
Zhijie Huang,
Jingfang Zhao,
Zhengshan Hong,
Kambiz Shahnazi,
Guo-Liang Jiang,
Qing Zhang

Affiliations

Weiwei Wang: Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
Ping Li: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center; Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
Yinxiangzi Sheng: Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
Zhijie Huang: Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
Jingfang Zhao: Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
Zhengshan Hong: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center; Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
Kambiz Shahnazi: Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
Guo-Liang Jiang: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center; Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
Qing Zhang: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center; Shanghai Key Laboratory of Radiation Oncology (20dz226100), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy

DOI: https://doi.org/10.1186/s13014-021-01801-w
Journal volume & issue: Vol. 16, no. 1
pp. 1 – 8

Abstract

Read online

Abstract Background The study objective was to establish the local effect model (LEM) rectum constraints for 12-, 8-, and 4-fraction carbon-ion radiotherapy (CIRT) in patients with localized prostate carcinoma (PCA) using microdosimetric kinetic model (MKM)-defined and LEM-defined constraints for 16-fraction CIRT. Methods We analyzed 40 patients with PCA who received 16- or 12-fraction CIRT at our center. Linear-quadratic (LQ) and RBE-conversion models were employed to convert the constraints into various fractionations and biophysical models. Based on them, the MKM LQ strategy converted MKM rectum constraints for 16-fraction CIRT to 12-, 8-, and 4-fraction CIRT using the LQ model. Then, MKM constraints were converted to LEM using the RBE-conversion model. Meanwhile the LEM LQ strategy converted MKM rectum constraints for 16-fraction CIRT to LEM using the RBE-conversion model. Then, LEM constraints were converted from 16-fraction constraints to the rectum constraints for 12-, 8-, and 4-fraction CIRT using the LQ model. The LEM constraints for 16- and 12-fraction CIRT were evaluated using rectum doses and clinical follow-up. To adapt them for the MKM LQ strategy, CNAO LEM constraints were first converted to MKM constraints using the RBE-conversion model. Results The NIRS (i.e. DMKM|v, V-20%, 10%, 5%, and 0%) and CNAO rectum constraints (i.e. DLEM|v, V-10 cc, 5 cc, and 1 cc) were converted for 12-fraction CIRT using the MKM LQ strategy to LEM 37.60, 49.74, 55.27, and 58.01 Gy (RBE), and 45.97, 51.70, and 55.97 Gy (RBE), and using the LEM LQ strategy to 39.55, 53.08, 58.91, and 61.73 Gy (RBE), and 49.14, 55.30, and 59.69 Gy (RBE). We also established LEM constraints for 8- and 4-fraction CIRT. The 10-patient RBE-conversion model was comparable to 30-patient model. Eight patients who received 16-fraction CIRT exceeded the corresponding rectum constraints; the others were within the constraints. After a median follow-up of 10.8 months (7.1–20.8), No ≥ G1 late rectum toxicities were observed. Conclusions The LEM rectum constraints from the MKM LQ strategy were more conservative and might serve as the reference for hypofractionated CIRT. However, Long-term follow-up plus additional patients is necessary.

Published in Radiation Oncology

ISSN: 1748-717X (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://ro-journal.biomedcentral.com/

About the journal

Abstract

Keywords