Assessment of Organs-at-Risk Dose Constraints in Prostate Cancer Radiotherapy
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Background: As one of the most widespread malignant tumours found among men worldwide, prostate cancer (PCa) has carried on demanding an ongoing search for improved therapeutic strategies. Radiotherapy (RT) plays a vital role in the overall treatment of PCa, particularly in the surgical curative stages. However, following surgery anatomical changes raise the susceptibility of anatomically adjacent organs at risk (OARs) such as bladder and rectum to radiation-induced toxicity.
Aim: This study aimed to analyze the recommended dose constraints for optimal coverage of OARs in prostate cancer radiotherapy by assessing modern RT techniques, including three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and stereotactic body radiotherapy (SBRT).
Material and methods: The present study was based on clinical data from 60 prostate cancer patients treated using consistent treatment planning protocols across several hospitals in Iraq. Dose calculations resulting from both the treatment planning system (TPS) and Monte Carlo simulations were compared to check the actual dose distributions. A comparative study of organ dosimetry established optimal dose constraints and treatment precisions.
Results: Under optimized conditions, significant variations still occur in organ dosimetry which requires precise dose constraints to achieve minimal toxicity; postoperative curing difficulties result in far too low therapeutic ratios for hypo fractionated therapies; the integration of image-guided radiotherapy systems (IGRS) and adaptive planning strategies helped to improve treatment accuracy.
Conclusions: This study underscores the need to develop individualized dose constraint protocols for OARs to improve treatment response and reduce complications in prostate cancer radiotherapy. The results call for the adjustment of postoperative dose control standards and consideration of the possible incorporation of sophisticated modalities such as proton therapy. Future research should focus on multicentric validation to develop clinical standards as well as elsewhere being carried.
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