What is the appropriate size criterion for proton radiotherapy for hepatocellular carcinoma? A dosimetric comparison of spot-scanning proton therapy versus intensity-modulated radiation therapy.
What is the appropriate size criterion for proton radiotherapy for hepatocellular carcinoma? A dosimetric comparison of spot-scanning proton therapy versus intensity-modulated radiation therapy.
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DOI：
10.1186/1748-717x-8-48
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发表时间：
2013-03-05
期刊：
影响因子：
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通讯作者：
Shirato H
中科院分区：
文献类型：
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作者：
Toramatsu C;Katoh N;Shimizu S;Nihongi H;Matsuura T;Takao S;Miyamoto N;Suzuki R;Sutherland K;Kinoshita R;Onimaru R;Ishikawa M;Umegaki K;Shirato H
我们对肝细胞癌（HCC）的点扫描质子治疗（SSPT）和调强放射治疗（IMRT）进行了剂量学比较，以研究肿瘤大小对放射性肝病（RILD）风险的影响。为10例HCC患者生成了许多替代计划。大体肿瘤体积（GTV）从20.1到2194.5 cm 3不等。假设所有GTV均为球形，计算标称直径，范围为3.4 - 16.1 cm。IMRT的处方剂量为60戈伊，SSPT的处方剂量为60钴Gy当量，计划靶区（PTV）覆盖率为95%。使用IMRT和SSPT技术，进行了广泛的比较计划。所有计划均通过使用Lyman正常组织并发症概率模型估计的RILD风险进行评估。对于调强放射治疗，在GTV标称直径为6.3-7.8 cm之间，RILD的风险急剧增加。当GTV标称直径大于6.3cm时，IMRT和SSPT的RILD发生率分别为94.5%和6.2%。关于RILD的风险，HCC可以用SSPT更安全地治疗，特别是如果其标称直径超过6.3 cm。
We performed a dosimetric comparison of spot-scanning proton therapy (SSPT) and intensity-modulated radiation therapy (IMRT) for hepatocellular carcinoma (HCC) to investigate the impact of tumor size on the risk of radiation induced liver disease (RILD). A number of alternative plans were generated for 10 patients with HCC. The gross tumor volumes (GTV) varied from 20.1 to 2194.5 cm3. Assuming all GTVs were spherical, the nominal diameter was calculated and ranged from 3.4 to 16.1 cm. The prescription dose was 60 Gy for IMRT or 60 cobalt Gy-equivalents for SSPT with 95% planning target volume (PTV) coverage. Using IMRT and SSPT techniques, extensive comparative planning was conducted. All plans were evaluated by the risk of RILD estimated using the Lyman-normal-tissue complication probability model. For IMRT the risk of RILD increased drastically between 6.3–7.8 cm nominal diameter of GTV. When the nominal diameter of GTV was more than 6.3 cm, the average risk of RILD was 94.5% for IMRT and 6.2% for SSPT. Regarding the risk of RILD, HCC can be more safely treated with SSPT, especially if its nominal diameter is more than 6.3 cm.