Assessment of tumour control probability and equivalent uniform dose in conventional 3D-CRT vs. hypo-fractionated IMRT

Abstract

Hypo-fractionated (HF) radiotherapy offers a promising solution to improve access to cancer treatment in resource-limited settings, such as developing countries, by reducing the number of treatment sessions compared to conventional fractionation (CF). For effective implementation, evaluating Equivalent Uniform Dose (EUD) and Tumour Control Probability (TCP) is essential to ensure treatment efficacy across different radiotherapy techniques. This study compares treatment plans generated using Three-Dimensional Conformal Radiation Therapy with Conventional Fractionation (3D-CRT CF) and Intensity Modulated Radiation Therapy with Hypo-fractionation (IMRT HF) in patients with localized prostate cancer. A total of 50 patients were CT-simulated, and their images were imported into a Treatment Planning System (TPS). Planning Target Volume (PTV) and Organs at Risk (OARs) were delineated. Both IMRT HF and 3D-CRT CF plans were generated using identical CT datasets and isocenter positioning. Cumulative Dose Volume Histograms (DVHs) were extracted, and EUD and TCP values were computed using the EUD program. The mean EUD for IMRT HF was 60.7 ± 2.63 Gy (97.92% of the prescribed dose), while for 3D-CRT CF, it was 71.58 ± 4.8 Gy (96.73% of the prescribed dose). Mean TCPs were 90.4 ± 4.61% and 95.6 ± 5.52% for IMRT HF and 3D-CRT CF, respectively. Results indicate comparable tumour control, with 3D-CRT CF showing slightly higher TCP.