Clinical results of conformal versus intensity-modulated radiotherapy using a focal simultaneous boost for muscle-invasive bladder cancer in elderly or medically unfit patients

Table 2 Treatment planning and delivery methods

	Elective			Boost^a
	Dose	Target organs	PTV	Dose^b	Delivery
3D-conformal	40 Gy	Bladder, prostate, and pelvic lymph nodes^c	Box technique, based on anatomical landmarks	55–60 Gy	Concomitant
IMRT	40 Gy	Bladder, prostate, and pelvic lymph nodes^c	Cranially and anteriorly: 15 mm.	55–60 Gy	Concomitant
IMRT	40 Gy	Bladder, prostate, and pelvic lymph nodes^c	Other directions: 8 mm	55–60 Gy	Simultaneously integrated^d
VMAT	40 Gy	Bladder, and pelvic lymph nodes^c	Cranially and anteriorly: 13 mm.	55–60 Gy	Simultaneously integrated
VMAT	40 Gy	Bladder, and pelvic lymph nodes^c	Other directions: 7 mm	55–60 Gy	Simultaneously integrated

^aIn case fiducial markers were present, a uniform boost margin of 10 mm was used. Otherwise, an adaptive margin strategy was employed
^bA dose of 60 Gy was standard after 2006. 55 Gy was chosen only when a dose of 60 Gy would result in a too high small bowel dose
^cLymph nodes were excluded from the elective field in case of comorbidities that required a target volume reduction
^dSimultaneous integration of the boost plan with the elective plan was implemented after October 2011

ISSN: 1748-717X