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Secondary malignancy risk for patients with localized prostate cancer after intensity-modulated radiotherapy with and without flattening filter

  • Men treated for localized prostate cancer by radiotherapy have often a remaining life span of 10 yr or more. Therefore, the risk for secondary malignancies should be taken into account. Plans for ten patients were evaluated which had been performed on an Oncentra (R) treatment planning system for a treatment with an Elekta Synergy (TM) linac with Agility (TM) head. The investigated techniques involved IMRT and VMTA with and without flattening filter. Different dose response models were applied for secondary carcinoma and sarcoma risk in the treated region and also in the periphery. As organs at risk we regarded for carcinoma risk urinary bladder, rectum, colon, esophagus, thyroid, and for sarcoma risk bone and soft tissue. The excess absolute risk (EAR) was found very similar in the treated region for both techniques (IMRT and VMAT) and also for both with and without flattening filter. The secondary sarcoma risk resulted about one magnitude smaller than the secondary carcinoma risk. The EAR to the peripheral organs was statistically significant reduced by application of the flattening filter free mode concerning the flattening filter as main source of scattered dose. Application of flattening filter free mode can thus support to reduce second malignancy risk for patients with localized prostate cancer.

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Metadaten
Author:Marius TreutweinORCiD, Rainer LöschelGND, Matthias Hipp, Oliver Kölbl, Barbara DoblerORCiD
DOI:https://doi.org/10.1002/acm2.13088
Parent Title (English):The Journal of Applied Clinical Medical Physics (JACMP)
Publisher:Wiley
Document Type:Article
Language:English
Year of first Publication:2020
Release Date:2022/01/31
Tag:2ND PRIMARY CANCERS; ARC THERAPY VMAT; BEAM; CARCINOMA; IMPACT; IMRT; PHOTON; RADIATION-THERAPY; RECTAL-CANCER; SOFT-TISSUE SARCOMA; VMAT; flattening filter free; localized prostate cancer; secondary malignancy risk
Volume:21
Issue:12
First Page:197
Last Page:205
Institutes:Fakultät Informatik und Mathematik
Begutachtungsstatus:peer-reviewed
OpenAccess Publikationsweg:Gold Open Access- Erstveröffentlichung in einem/als Open-Access-Medium
research focus:Lebenswissenschaften und Ethik
Licence (German):Creative Commons - CC BY - Namensnennung 4.0 International