A dosimetric comparison for SBRT plans of localized prostate cancer between Cyberknife and Varian Truebeam STX device

• Published in: Applied radiation and isotopes 2023-02, Vol.192, p.110617-110617, Article 110617
• Main Authors: Şenişik, Ahmet Murat, Okutan, Murat, Çakir, Aydın, Iribaş Çelik, Ayça, Kaytan Sağlam, Esra, Çevikbaş, Görkem, Demir, Bayram
• Format: Article
• Language: English
• Subjects: CyberKnife (CK); Humans; Localized prostate cancer; Male; Prostatic Neoplasms - radiotherapy; Radiosurgery - methods; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted - methods; Radiotherapy, Intensity-Modulated - methods; Stereotactic body radiotherapy (SBRT); Volumetric modulated arc therapy (VMAT)
• ISSN: 0969-8043; 1872-9800
• DOI: 10.1016/j.apradiso.2022.110617

As the Stereotactic Body Radiotherapy (SBRT) approach began to increase in treating patients with localized prostate cancer, it became necessary to investigate which methods used in practice were better. The aim of this study is to perform a dosimetric comparison of the advantages and disadvantages of SBRT treatments for localized prostate cancer delivered by CyberKnife (CK) and Varian Truebeam STX (FF and FFF). Seventeen intermediate and high-risk patients with localized prostate cancer were included in the study. SBRT plans for the CK system and Varian Truebeam STX systems with and without Flattening Filters (Tru-FF and Tru-FFF) were prepared for each patient. Plans prepared for each patient were planned at a fraction dose of 6.7 Gy at 6 MV energy and a target dose of 33.5 Gy in 5 fractions. For all plans, cumulative dose-volume histograms (DVHs) were generated for target volumes and organs at risk (OAR). The maximum doses of PTV (41 Gy) in CK plans are higher than the maximum doses (35 Gy) in VMAT plans prepared with Tru-FF or Tru-FFF beams. The mean dose of the rectal wall (10.06 ± 2.40Gy for CK) is still relatively low compared to other plans (13.46 ± 2.16 Gy for Tru-FF and 13.61 ± 2.32 Gy for Tru-FFF). The bladder wall (14 Gy for CK, 26 Gy for Tru-FF and Tru-FFF) and femoral head (6.8 Gy for CK, 9 Gy for Tru-FF and 9.4 Gy Tru-FFF) doses were also lower for CK plans. The CK plans provide better tumour control due to low doses in critical organs and high target doses than the Tru-FF or Tru-FFF plans. It was observed that CK and VMAT plans for SBRT with 6 MV photon beams provided acceptable results in term of treatment planning criteria such as Conformity Index and Homogeneity Index. It is recommended to use a target tracking system to provide an accurate and reliable SBRT treatment with VMAT and CK techniques. •SBRT with an image-guided system provides dose accuracy and precision at the target volume for prostate cancer.•CK and VMAT plans are acceptable plans as an SBRT technique in patients with localized prostate cancer.•There is no statistically significant difference in terms of HI, GI, treatment time, PTV and OAR doses between VMAT plans.•Prolonged treatment time may affect patient immobility. Thus, it is advantage that VMAT plans have a shorter treatment time.•Target is treated accurately in CK, lower doses are provided in bladder wall, rectum and femur thanks to real-time tracking system.