Treatment plan comparison of linac step and shoot, tomotherapy, rapidarc, and proton therapy for prostate cancer by using the dosimetrical and the biological indices

Suk Lee, Yuan Jie Cao, Kyung Hwan Chang, Jang Bo Shim, Kwang Hyeon Kim, Nam Kwon Lee, Young Je Park, Chul Yong Kim, Sam Ju Cho, Sang Hoon Lee, Chul Kee Min, Woo Chul Kim, Kwang Hwan Cho, Hyun Do Huh, Sangwook Lim, Dongho Shin

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The purpose of this study was to use various dosimetrical indices to determine the best intensitymodulated radiation therapy (IMRT) modality - for treating patients with prostate cancer. Ten patients with prostate cancer were included in this study. IMRT plans were designed to include different modalities, including the linac step and shoot, tomotherapy, RapidArc, and proton systems. Various dosimetrical indices, like the prescription isodose to target volume (PITV) ratio, conformity index (CI), homogeneity index (HI), target coverage index (TCI), modified dose homogeneity index (MHI), conformation number (CN), critical organ scoring index (COSI), and quality factor (QF), were determined to compare the different treatment plans. Biological indices, such as the generalized equivalent uniform dose (gEUD) based the tumor control probability (TCP), and the normal tissue complication probability (NTCP), were also calculated and used to compare the treatment plans. The RapidArc plan attained better PTV coverage, as evidenced by its superior PITV, CI, TCI, MHI, and CN values. Regarding organ at risks (OARs), proton therapy exhibited superior dose sparing for the rectum and the bowel in low dose volumes, whereas the tomotherapy and RapidArc plans achieved better dose sparing in high dose volumes. The QF scores showed no significant difference among these plans (p = 0.701). The average TCPs for prostate tumors in the RapidArc, linac and proton plans were higher than the average TCP for Tomotherapy (98.79%, 98.76%, and 98.75% vs. 98.70%, respectively). Regarding the rectum NTCP, RapidArc showed the most favorable result (0.09%) whereas linac resulted in the best bladder NTCP (0.08%).

Original languageEnglish
Pages (from-to)7-16
Number of pages10
JournalJournal of the Korean Physical Society
Issue number1
Publication statusPublished - 2015 Jul 31



  • Dosimetrical index
  • Intensity modulated radiation therapy (IMRT)
  • Prostate cancer
  • Radiobiological index

ASJC Scopus subject areas

  • Physics and Astronomy(all)

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