A Comparison of Field-in-Field and Intensity Modulated Radiation Therapy in Delivering Hypofractionated Radiation Therapy for Prostate Cancer

Hawbir Ghafour; Jalil S Ali; Ronak Taher Ali; Elhussien Sirelkhatim

doi:10.1016/j.adro.2023.101356

A Comparison of Field-in-Field and Intensity Modulated Radiation Therapy in Delivering Hypofractionated Radiation Therapy for Prostate Cancer

Adv Radiat Oncol. 2023 Aug 15;9(2):101356. doi: 10.1016/j.adro.2023.101356. eCollection 2024 Feb.

Authors

Hawbir Ghafour¹, Jalil S Ali¹, Ronak Taher Ali², Elhussien Sirelkhatim³

Affiliations

¹ Zhianawa Cancer Center, Kurdistan, Iraq.
² College of Medicine, Hawler Medical University, Erbil, Iraq.
³ Radiation and Isotopes Centre, Khartoum, Sudan.

Abstract

Purpose: This study compares the dosimetric performance of the field-in-field (FIF) technique with intensity modulated radiation therapy (IMRT) for delivering hypofractionated radiation therapy to prostate patients with cancer. The FIF technique uses 6 beams, whereas IMRT uses 9 beams.

Methods and materials: This study was conducted on 15 patients with prostate cancer treated with step-and-shoot IMRT. The prescribed dose was 60 Gy in 20 fractions. The FIF plans contained 6 photon beams, and IMRT plans were designed using a 9-field step-and-shoot technique. Dose-volume histograms and dose distributions were evaluated to compare FIF and IMRT.

Results: The results of the planning target volume indices analysis showed a significant difference in the maximum dose, dose to 2% of volume, and homogeneity index in favor of FIF and in the mean dose, dose to 98% of volume, and D95 in favor of IMRT. The results of the organs-at-risk analysis showed significant differences in the volume of the rectum and bladder receiving 60 Gy in favor of FIF and the volume of the rectum and femoral heads receiving 30 Gy, as well as the mean dose to the rectum, in favor of IMRT. IMRT had a higher median number of monitor units (MUs) and segments (886 MU, 64 segments) compared to FIF (434 MUs, 6 segments).

Conclusions: The FIF technique and IMRT had comparable results in delivering hypofractionated radiation therapy for prostate cancer. The findings of this study may aid in decision-making for patients undergoing treatment.