Comparison of intensity-modulated radiotherapy, adaptive radiotherapy, proton radiotherapy, and adaptive proton radiotherapy for treatment of locally advanced head and neck cancer.
Comparison of intensity-modulated radiotherapy, adaptive radiotherapy, proton radiotherapy, and adaptive proton radiotherapy for treatment of locally advanced head and neck cancer.
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DOI：
10.1016/j.radonc.2011.05.028
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发表时间：
2011-12
期刊：
影响因子：
--
通讯作者：
Simone NL
中科院分区：
文献类型：
--
作者：
Simone CB 2nd;Ly D;Dan TD;Ondos J;Ning H;Belard A;O'Connell J;Miller RW;Simone NL
针对局部晚期头颈部鳞状细胞癌(SCCHN)，人们提出了各种放射治疗计划方法，以减少正常组织的毒性。我们比较了调强放射治疗、适应性调强放射治疗、质子治疗(IMPT)和适应性IMPT治疗SCCHN。使用连续10例SCCHN患者的初始和重新模拟CT图像来量化光子和质子治疗之间的剂量学差异。在两个CT上进行等高线绘制，并生成计划(n=40个计划)和剂量体积直方图。重新模拟后，平均GTV体积减少53.4%。所有计划都提供了类似的PTV报道。与调强放射治疗相比，自适应调强放射治疗显著降低了下颌骨的最大剂量(p=0.020)和对侧腮腺(p=0.049)和喉部的平均剂量(p=0.049)。与调强放疗和适应性调强放疗相比，IMPT显著降低了脊髓(P<；0.002)和脑干(P<；0.002)的最大剂量和喉部(P<；0.002)、同侧(p=0.004，p=0.050，p=0.050)和对侧(p<；0.002，p=0.010，适应性)腮腺的平均剂量。与调强放疗和自适应调强放疗相比，自适应IMPT显著减少了对所有关键结构的剂量，与非适应性IMPT相比，对几个关键结构的剂量显著减少。尽管与标准调强放射治疗相比，自适应调强放射治疗减少了对几个正常结构的剂量，但非适应性质子治疗具有比调强放疗或自适应调强放疗更有利的剂量分布，并可能消除对适应性计划的需要。质子可以显著保留脊髓、腮腺、喉和脑干，应考虑将其用于SCCHN，以减少正常组织毒性，同时仍提供最佳的肿瘤覆盖。
Various radiotherapy planning methods for locally advanced squamous cell carcinoma of the head and neck (SCCHN) have been proposed to decrease normal tissue toxicity. We compare IMRT, adaptive IMRT, proton therapy (IMPT), and adaptive IMPT for SCCHN. Initial and re-simulation CT images from 10 consecutive patients with SCCHN were used to quantify dosimetric differences between photon and proton therapy. Contouring was performed on both CTs, and plans (n=40 plans) and dose volume histograms were generated. The mean GTV volume decreased 53.4% with re-simulation. All plans provided comparable PTV coverage. Compared with IMRT, adaptive IMRT significantly reduced the maximum dose to the mandible (p=0.020) and mean doses to the contralateral parotid gland (p=0.049) and larynx (p=0.049). Compared with IMRT and adaptive IMRT, IMPT significantly lower the maximum doses to the spinal cord (p<0.002 for both) and brainstem (p<0.002 for both) and mean doses to the larynx (p<0.002 for both) and ipsilateral (p=0.004 IMRT, p=0.050 adaptive) and contralateral (p<0.002 IMRT, p=0.010 adaptive) parotid glands. Adaptive IMPT significantly reduced doses to all critical structures compared with IMRT and adaptive IMRT and several critical structures compared with non-adaptive IMPT. Although adaptive IMRT reduced dose to several normal structures compared with standard IMRT, non-adaptive proton therapy had a more favorable dosimetric profile than IMRT or adaptive IMRT and may obviate the need for adaptive planning. Protons allowed significant sparing of the spinal cord, parotid glands, larynx, and brainstem and should be considered for SCCHN to decrease normal tissue toxicity while still providing optimal tumor coverage.
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影响因子：
5.7
作者：
Melzner, Winfrid J.;Lotter, Michael;Strnad, Vratislav
通讯作者：
Strnad, Vratislav
DOI：
10.1016/j.ijrobp.2005.07.957
发表时间：
2006-02-01
影响因子：
7
作者：
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通讯作者：
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DOI：
10.1016/s1278-3218(02)00222-6
发表时间：
2002-12-01
期刊：
Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique
影响因子：
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作者：
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通讯作者：
Mazeron, J J
影响因子：
5.7
作者：
Broggi, Sara;Fiorino, Claudio;Calandrino, Riccardo
通讯作者：
Calandrino, Riccardo
DOI：
10.1016/j.ijrobp.2008.03.007
发表时间：
2008-12-01
影响因子：
7
作者：
Hui, Zhouguang;Zhang, Xiaodong;Chang, Joe Y.
通讯作者：
Chang, Joe Y.