Controlling heterogeneity within the lymphatic target volume for dose painted treatment of prostate cancer |
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| Affiliation: | 2. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan;3. Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan;4. Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan;5. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;2. Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Higashihiroshima, Japan;2. Queensland University of Technology, Brisbane, Australia;3. ICON Cancer Centres, Springfield, Australia;4. Cancer Care Services, Royal Brisbane and Women''s Hospital, Brisbane, Australia;2. Department of Radiotherapy, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan;3. Department of Regional Cancer Network, Yamagata University Faculty of Medicine, Yamagata, Japan;4. Department of Radiology, University of Yamanashi, Yamanashi, Japan |
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| Abstract: | Introduction: For patients with high risk prostate cancer, conventionally fractionated treatment of the pelvic lymphatics and hypofractionated treatment to the prostate can be delivered simultaneously with dose painting. The purpose of this technical note is to highlight unexpected hot spots within the low dose lymphatic target volume as a clinical problem that we have observed with dose painting, and to describe a simple approach to account for this during treatment planning.Summary: We describe the creation of a control structure that can be incorporated into the optimization objective function. An upper constraint objective can be placed on the control structure such that heterogeneity within the plan is limited to the area near the high dose target volume and better emulates the dosimetry of a conventionally fractionated sequential boost plan. |
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