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Potential benefits of adaptive intensity-modulated proton therapy in nasopharyngeal carcinomas.
Minatogawa, Hideki; Yasuda, Koichi; Dekura, Yasuhiro; Takao, Seishin; Matsuura, Taeko; Yoshimura, Takaaki; Suzuki, Ryusuke; Yokota, Isao; Fujima, Noriyuki; Onimaru, Rikiya; Shimizu, Shinichi; Aoyama, Hidefumi; Shirato, Hiroki.
Afiliación
  • Minatogawa H; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
  • Yasuda K; Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
  • Dekura Y; Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan.
  • Takao S; Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
  • Matsuura T; Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan.
  • Yoshimura T; Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan.
  • Suzuki R; Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan.
  • Yokota I; Department of Health Sciences and Technology, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
  • Fujima N; Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan.
  • Onimaru R; Department of Biostatistics, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
  • Shimizu S; Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
  • Aoyama H; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
  • Shirato H; Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan.
J Appl Clin Med Phys ; 22(1): 174-183, 2021 Jan.
Article en En | MEDLINE | ID: mdl-33338323
PURPOSE: To investigate potential advantages of adaptive intensity-modulated proton beam therapy (A-IMPT) by comparing it to adaptive intensity-modulated X-ray therapy (A-IMXT) for nasopharyngeal carcinomas (NPC). METHODS: Ten patients with NPC treated with A-IMXT (step and shoot approach) and concomitant chemotherapy between 2014 and 2016 were selected. In the actual treatment, 46 Gy in 23 fractions (46Gy/23Fx.) was prescribed using the initial plan and 24Gy/12Fx was prescribed using an adapted plan thereafter. New treatment planning of A-IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A-IMXT with A-IMPT. RESULTS: The means of the Dmean of the right parotid gland (P < 0.001), right TM joint (P < 0.001), left TM joint (P < 0.001), oral cavity (P < 0.001), supraglottic larynx (P = 0.001), glottic larynx (P < 0.001), , middle PCM (P = 0.0371), interior PCM (P < 0.001), cricopharyngeal muscle (P = 0.03643), and thyroid gland (P = 0.00216), in A-IMPT are lower than those of A-IMXT, with statistical significance. The means of, D0.03cc , and Dmean of each sub portion of auditory apparatus and D30% for Eustachian tube and D0.5cc for mastoid volume in A-IMPT are significantly lower than those of A-IMXT. The mean doses to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20 Gy (RBE = 1.1). CONCLUSIONS: An adaptive approach is suggested to enhance the potential benefit of IMPT compared to IMXT to reduce adverse effects for patients with NPC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Nasofaríngeas / Radioterapia de Intensidad Modulada / Terapia de Protones Límite: Humans Idioma: En Revista: J Appl Clin Med Phys Asunto de la revista: BIOFISICA Año: 2021 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Nasofaríngeas / Radioterapia de Intensidad Modulada / Terapia de Protones Límite: Humans Idioma: En Revista: J Appl Clin Med Phys Asunto de la revista: BIOFISICA Año: 2021 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos