Comparison of helical tomotherapy with multi-field intensity-modulated radiotherapy treatment plans using simultaneous integrated boost in high-risk prostate cancer

Purpose: The aim of this study is to compare the dosimetric results of Helical Tomotherapy (HT) and Multi-field IMRT treatment plans using a Simultaneous Integrated Boost (SIB) technique in the treatment of High-Risk Prostate Cancer (HRPCa) with pelvic nodal radiation. Methods: Seventeen patients planned with HT and 7,8 and 9 fields IMRT were investigated. All plans were designed with the prescribed dose of 54.0 Gy to the PTVln while simultaneously delivering 74.0 Gy to the PTVPS in 30 fractions. Dosimetric data of PTV and OARs were compared. Results: HT gives a better CI and HI of PTVPS compared to multi- field IMRT plans. HT plans significantly improved target coverage (HT:0.95 vs multi-field IMRT: 0.52, 0.49 and 0.49 respectively, p < 0.001). Bladder mean dose(Gy) (HT: 45.6 vs multi-field IMRT: 53.6, 53.3 and 52.7 respectively, p = 0.004) and D66%(Gy) dose (HT: 35.3 vs multi-field IMRT: 46.7, 47.0 and 44.9 respectively, p = 0.006) were lower in HT. But multi-field IMRT plans significantly reduced the rectum volume receiving more than 75 Gy; (HT V75% (%) 2.7 vs multi-field IMRT 0.8, 1.4 and 0.9 respectively, p = 0.008). HT provided better sparing of the right and left femoral head receiving a mean dose. The penile bulb and small bowel doses were the highest in HT compared with multi-field IMRT. Conclusions: HT achieved better dose distribution to target compared to multi-field IMRT. This study suggests HT as a reasonable option for the treatment of HRPCa patients.