Prostate radiotherapy treatment plan quality : effects of hip prostheses

Kairn, T., Crowe, S. B., & Trapp, J. V. (2014) Prostate radiotherapy treatment plan quality : effects of hip prostheses. Australasian Physical and Engineering Sciences in Medicine, 37(1), p. 198.

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This study aimed to examine the geometric and dosimetric results when radiotherapy treatment plans are designed for prostate cancer patients with hip prostheses.


Ten EBRT treatment plans for localised prostate cancer, in the presence of hip prostheses, were analysed and compared with a reference set of 196 treatment plans for localised prostate cancer in patients without prostheses. Crowe et al.’s TADA code [1] was used to extract treatment plan parameters and evaluate doses to target volumes and critical structures against recommended goals [2] and constraints [3, 4].


The need to avoid transmitting the radiation beam through the hip prostheses limited the range of gantry angles available for use in both the rotational (VMAT) and the non-rotational (3DCRT and IMRT) radiotherapy treatments. This geometric limitation (exemplified in the VMAT data shown in Fig. 1) reduced the overall quality of the treatment plans for patients with prostheses compared to the reference plans. All plans with prostheses failed the PTV dose homogeneity requirement [2], whereas only 4 % of the plans without prostheses failed this test. Several treatment plans for patients with hip prostheses also failed the QUANTEC requirements that less than 50 % of the rectum receive 50 Gy and less than 35 % of the rectum receive 60 Gy to keep the grade 3 toxicity rate below 10 % [3], or the Hansen and Roach requirement that less than 25 % of the bladder receive 75 Gy [4].

Discussion and conclusions

The results of this study exemplify the difficulty of designing prostate radiotherapy treatment plans, where beams provide adequate doses to targeted tissues while avoiding nearby organs at risk, when the presence of hip prostheses limits the available treatment geometries. This work provides qualitative evidence of the compromised dose distributions that can result, in such cases.

Impact and interest:

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ID Code: 71402
Item Type: Journal Article
Refereed: Yes
Additional URLs:
DOI: 10.1007/s13246-014-0248-y
ISSN: 1879-5447
Subjects: Australian and New Zealand Standard Research Classification > PHYSICAL SCIENCES (020000) > OTHER PHYSICAL SCIENCES (029900) > Medical Physics (029903)
Divisions: Current > QUT Faculties and Divisions > Science & Engineering Faculty
Deposited On: 12 May 2014 22:53
Last Modified: 21 Jun 2017 07:01

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