The clinical target volume (CTV) covered the prostatic fossa as defined by the guidelines of the Radiation Therapy Oncology Group (RTOG) (15 (link)). The CTV was expanded by 7 mm to create a planning target volume (PTV), and the prescribed dose was 68 Gy in 34 fractions of 2 Gy. Radiotherapy planning was performed with the RayStation planning system (RaySearch Laboratories, Stockholm, Sweden), and dose constraints to the organs-at-risk (OAR) were defined based on the Quantitative Analyses of Normal Tissue Effects in the Clinic (16 (link)–18 (link)). Patients were instructed to present to daily treatment with an empty bowel and a comfortably filled bladder, and patient immobilization for treatment was carried out using a ProStep™ pelvic and lower extremity support (Elekta, Stockholm, Sweden). Treatment was applied as step-and-shoot IMRT on an Artiste linear accelerator (Siemens, Erlangen, Germany) using 9 co-planar fields.
Raystation planning system
Manufactured by RaySearch Laboratories
Sourced in Sweden
RayStation is a comprehensive radiation therapy treatment planning system. It provides functionality for treatment planning, plan optimization, and dose calculation. The system supports a variety of radiation therapy techniques, including intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and proton therapy.
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Lab products found in correlation
4 protocols using raystation planning system
1
Radiotherapy for Prostate Cancer
2
Prostate Cancer Radiotherapy Dosimetry
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For all patients, the clinical target volume (CTV) comprised the prostate gland for low-risk tumors and additionally 10–15 mm of the proximal seminal vesicles for intermediate-risk cancers. A setup margin of 7 mm was added to the CTV to create a planning target volume (PTV). The prescribed dose was 76.50 Gy in 34 fractions of 2.25 Gy. Dose constraints to the organs-at risk (OAR) were based on the Quantitative Analyses of Normal Tissue Effects in the Clinic (14 (link)–16 (link)). Patients were immobilized with a ProStep™ pelvic and lower extremity support (Elekta, Stockholm, Sweden), and were instructed to present to daily treatment with an empty bowel and a comfortably filled bladder. Treatment plans were generated using the RayStation planning system (RaySearch Laboratories, Stockholm, Sweden), and step-and-shoot IMRT was applied using 9 co-planar fields on an Artiste linear accelerator (Siemens, Erlangen, Germany).
3
Hypofractionated IMRT for Prostate Cancer
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Patient immobilization was carried out using a ProStepTM pelvic and lower extremity support (Elekta, Stockholm, Sweden). No patient received implanted fiducials prior to radiotherapy. The clinical target volume (CTV) covered the prostate gland for low-risk tumors and also the base of the seminal vesicles for intermediate-risk cancers. The planning target volume (PTV) comprised an additional 7 mm as a setup margin. Treatment plans were generated based on the hypofractionated arm of the CHHiP trial to a total dose of 60 Gy in 20 fractions of 3 Gy (7 (link)). Dose constraints to the organs-at risk (OARs) were defined in accordance with the Quantitative Analyses of Normal Tissue Effects in the Clinic (21 (link)–23 (link)). Treatment plans for a step-and-shoot IMRT using 9 co-planar fields were generated on the RayStation planning system (RaySearch Laboratories, Stockholm, Sweden). All patients were instructed to present to each treatment fraction with a comfortably filled bladder and an empty rectum.
4
VMAT Treatment Planning with NTCP-Guided Optimization
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VMAT treatment planning was performed in the RayStation planning system (RaySearch Laboratories, Stockholm, Sweden). The clinical plans, created in the clinical version, were imported in a research version of the system (version 10B -R, build 10.1.100.0) offering functionalities not yet implemented in the clinical version. Subsequently, QOL-weighted NTCP-guided plans were created. Two full arcs were used with all plans and the primary objectives for all plans were identical: at least 98% of each PTV had to be covered with 95% of the prescribed dose, the maximum doses delivered to the spinal cord, brainstem, optic nerves, and optic chiasm were not allowed to exceed 54 Gy, 60 Gy, 54 Gy and 54 Gy, respectively. The maximum plan dose was not allowed to exceed 77 Gy and the volume receiving 75 Gy was not allowed to be larger than 2 cm 3 (Supplementary Table 2). For all plans, dose optimisation included a series of optimisation sequences, each consisting of 80 automated iterations, and a trial-and-error adaptive adjustment of the objectives' values and weights until a clinical acceptable solution was reached. The Collapsed Cone v5.3 algorithm was used for all final dose calculations. The only difference between clinical and QOL-weighted NTCPguided plans was how OAR dose was optimised.
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