Catheter Placement Optimization using Hybrid Inverse Planning and Optimization for Focal High Dose Rate Brachytherapy in Patients with Pubic Arch Interference
Date
2021-09-20
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Positive clinical outcomes are well correlated with an increase in dose delivered to the Dominant Intraprostatic Lesion (DIL) in prostate cancer radiotherapy treatments. The DIL represents a concentration of high-grade cancerous tissue and is the most common site of prostate cancer recurrence. One of the most promising tools to achieve dose escalation is via focal High Dose Rate Brachytherapy (FHDR-BT). Traditionally, HDR-BT is used along with External Beam Radiotherapy (EBRT) to deliver a whole prostate boost for unfavourable intermediate and high-risk patients or as a monotherapy alternative for low, very low, and favourable intermediate patients. However, with the introduction of new imaging techniques such as multiparametric Magnetic Resonance Imaging (mp-MRI), there is the potential to further escalate the dose to the DIL. Currently, there is limited information on the impact of Pubic Arch Interference (PAI) in dose escalation therapies such as FHDR-BT. In this work, we use Hybrid Inverse Planning and Optimization (HIPO) to simulate the planning of clinically representative scenarios built using a cohort of patients with Pubic Arch Interference (PAI), previously treated at our institution. We simulate varying levels of PAI by changing the location of the DIL. In addition, we also test the capability of HIPO to create clinically satisfactory plans under challenging anatomical conditions of PAI and prostate size. The results presented in this investigation show that HIPO can be used as an effective tool for dose escalation to the DIL in patients with PAI.
Description
Keywords
Brachytherapy, Optimization, Focal
Citation
Martinez Fernandez, P. E. (2021). Catheter Placement Optimization using Hybrid Inverse Planning and Optimization for Focal High Dose Rate Brachytherapy in Patients with Pubic Arch Interference (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.