PMID- 34544468
OWN - NLM
STAT- MEDLINE
DCOM- 20220124
LR  - 20230921
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 16
IP  - 1
DP  - 2021 Sep 20
TI  - The feasibility of a dose painting procedure to treat prostate cancer based on 
      mpMR images and hierarchical clustering.
PG  - 182
LID - 10.1186/s13014-021-01906-2 [doi]
LID - 182
AB  - BACKGROUND: We aimed to assess the feasibility of a dose painting (DP) procedure, 
      known as simultaneous integrated boost intensity modulated radiation Therapy 
      (SIB-IMRT), for treating prostate cancer with dominant intraprostatic lesions 
      (DILs) based on multi-parametric magnetic resonance (mpMR) images and 
      hierarchical clustering with a machine learning technique. METHODS: The mpMR 
      images of 120 patients were used to create hierarchical clustering and draw a 
      dendrogram. Three clusters were selected for performing agglomerative clustering. 
      Then, the DIL acquired from the mpMR images of 20 patients were categorized into 
      three groups to have them treated with a DP procedure being composed of three 
      planning target volumes (PTVs) determined as PTV1, PTV2, and PTV3 in treatment 
      plans. The DP procedure was carried out on the patients wherein a total dose of 
      80, 85 and 91 Gy were delivered to the PTV1, PTV2, and PTV3, respectively. 
      Dosimetric and radiobiologic parameters [Tumor Control Probability (TCP) and 
      Normal Tissue Complication Probability (NTCP)] of the DP procedure were compared 
      with those of the conventional IMRT and Three-Dimensional Conformal Radiation 
      Therapy (3DCRT) procedures carried out on another group of 20 patients. A 
      post-treatment follow-up was also made four months after the radiotherapy 
      procedures. RESULTS: All the dosimetric variables and the NTCPs of the organs at 
      risks (OARs) revealed no significant difference between the DP and IMRT 
      procedures. Regarding the TCP of three investigated PTVs, significant differences 
      were observed between the DP versus IMRT and also DP versus 3DCRT procedures. At 
      post-treatment follow-up, the DIL volumes and apparent diffusion coefficient 
      (ADC) values in the DP group differed significantly (p-value < 0.001) from those 
      of the IMRT. However, the whole prostate ADC and prostate-specific antigen (PSA) 
      indicated no significant difference (p-value > 0.05) between the DP versus IMRT. 
      CONCLUSIONS: The results of this comprehensive clinical trial illustrated the 
      feasibility of our DP procedure for treating prostate cancer based on mpMR images 
      validated with acquired patients' dosimetric and radiobiologic assessment and 
      their follow-ups. This study confirms significant potential of the proposed DP 
      procedure as a promising treatment planning to achieve effective dose escalation 
      and treatment for prostate cancer. TRIAL REGISTRATION: IRCT20181006041257N1; 
      Iranian Registry of Clinical Trials, Registered: 23 October 2019, 
      https://en.irct.ir/trial/34305 .
CI  - (c) 2021. The Author(s).
FAU - Rezaeijo, Seyed Masoud
AU  - Rezaeijo SM
AD  - Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares 
      University, Al-Ahmad and Chamran Cross, 1411713116, Tehran, Iran.
FAU - Hashemi, Bijan
AU  - Hashemi B
AUID- ORCID: 0000-0002-2511-4376
AD  - Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares 
      University, Al-Ahmad and Chamran Cross, 1411713116, Tehran, Iran. 
      bhashemi@modares.ac.ir.
FAU - Mofid, Bahram
AU  - Mofid B
AD  - Department of Radiation Oncology, Faculty of Medicine, Shahid Beheshti University 
      of Medical Sciences, Tehran, Iran.
FAU - Bakhshandeh, Mohsen
AU  - Bakhshandeh M
AD  - Department of Radiology Technology, Faculty of Paramedical Sciences, Shahid 
      Beheshti University of Medical Sciences, Tehran, Iran.
FAU - Mahdavi, Arash
AU  - Mahdavi A
AD  - Department of Radiology, Modares Hospital, Shahid Beheshti University of Medical 
      Sciences, Tehran, Iran.
FAU - Hashemi, Mohammad Saber
AU  - Hashemi MS
AD  - Department of Aerospace Engineering, Iowa State University, Ames, IA, 50011, USA.
LA  - eng
GR  - Med-77234/Tarbiat Modares University/
PT  - Journal Article
DEP - 20210920
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
SB  - IM
MH  - Aged
MH  - Cluster Analysis
MH  - Feasibility Studies
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Organs at Risk
MH  - Prostatic Neoplasms/diagnostic imaging/*radiotherapy
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Intensity-Modulated/adverse effects/*methods
PMC - PMC8454023
OTO - NOTNLM
OT  - 3DCRT
OT  - Dose painting
OT  - Hierarchical clustering
OT  - IMRT
OT  - Prostate cancer
OT  - mpMR images
COIS- The authors declare no competing interests.
EDAT- 2021/09/22 06:00
MHDA- 2022/01/27 06:00
PMCR- 2021/09/20
CRDT- 2021/09/21 05:38
PHST- 2021/06/14 00:00 [received]
PHST- 2021/09/06 00:00 [accepted]
PHST- 2021/09/21 05:38 [entrez]
PHST- 2021/09/22 06:00 [pubmed]
PHST- 2022/01/27 06:00 [medline]
PHST- 2021/09/20 00:00 [pmc-release]
AID - 10.1186/s13014-021-01906-2 [pii]
AID - 1906 [pii]
AID - 10.1186/s13014-021-01906-2 [doi]
PST - epublish
SO  - Radiat Oncol. 2021 Sep 20;16(1):182. doi: 10.1186/s13014-021-01906-2.