A treatment planning comparison of photon stereotactic ablative radiotherapy and proton beam therapy for the re-irradiation of pelvic cancer recurrence.
A treatment planning comparison of photon stereotactic ablative radiotherapy and proton beam therapy for the re-irradiation of pelvic cancer recurrence.
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DOI：
10.1016/j.phro.2022.02.010
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发表时间：
2022-01
影响因子：
--
通讯作者：
Handley J
中科院分区：
文献类型：
--
作者：
Chuter R;Glassborow E;Speight R;Clarke M;Murray L;Radhakrishna G;Lavin V;Aspin L;Aldred M;Gregory S;Richardson J;Handley J
在接受初始放射治疗的区域或附近发生盆腔癌复发的患者通常没有什么治疗选择。处于危险中的器官 (OAR) 通常已达到其剂量限制极限，留下用于标准再照射 (reRT) 的最小剂量。然而，尽管满足 OAR 限制可能具有挑战性，但基于光子的立体定向消融放射治疗 (SABR) 已用于再放射治疗，并取得了有希望的初步结果。质子束治疗（PBT）可以提供一个优势。将用于治疗 10 名骨盆 reRT 患者的 SABR 计划与使用相同 CT 和轮廓数据回顾性计划的 PBT 计划进行剂量学比较。创建 PBT 计划是为了与 SABR 治疗计划的 CTV 剂量覆盖率相匹配，V100% ≥95%。考虑到初始辐射的 OAR 剂量（使用 2 Gy 分数中的等效剂量），对 OAR 耐受性采取“尽可能低”的方法。相关 OAR 统计数据的剂量学比较显示，所有患者中使用 PBT 的 OAR 剂量均低于 SABR，且目标覆盖范围相当。结肠 D0.5 cm3 的降幅最大，具有统计学意义，中值降幅从 13.1 Gy 降至 5.9 Gy。小肠、骶丛和马尾的中位剂量有统计学上显着的减少。与 SABR 相比，PBT 在骨盆 reRT 环境中具有显着减少 OAR 剂量的潜力。然而，目前尚不清楚这些 OAR 剂量减少的幅度是否会转化为临床益处。
Patients who experience a pelvic cancer recurrence in or near a region that received initial radiotherapy, typically have few options for treatment. Organs at risk (OAR) have often reached their dose constraint limits leaving minimal dose remaining for standard re-irradiation (reRT). However, photon based stereotactic ablative radiotherapy (SABR) has been utilised for reRT with promising initial results although meeting OAR constraints can be challenging. Proton beam therapy (PBT) could offer an advantage. SABR plans used for treatment for ten pelvic reRT patients were dosimetrically compared to PBT plans retrospectively planned using the same CT and contour data. PBT plans were created to match the CTV dose coverage of SABR treatment plans with V100% ≥95%. An ‘as low as reasonably achievable’ approach was taken to OAR tolerances with consideration of OAR dose from the initial radiation (using equivalent dose in 2 Gy fractions). Dosimetric comparison of relevant OAR statistics showed a decrease in OAR dose using PBT over SABR in all patients, with equivalent target coverage. The largest statistically significant reduction was seen for the colon D0.5 cm3 with a median reduction from 13.1 Gy to 5.9 Gy. There were statistically significant dose reductions in the median dose to small bowel, sacral plexus and cauda equina. PBT has the potential for significant dose reductions for OARs in the pelvic reRT setting compared to SABR. However, it remains unclear if the magnitude of these OAR dose reductions will translate into clinical benefit.
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影响因子：
2.3
作者：
Koroulakis A;Molitoris J;Kaiser A;Hanna N;Bafford A;Jiang Y;Bentzen S;Regine WF
通讯作者：
Regine WF
影响因子：
3.6
作者：
Marnitz, Simone;Wlodarczyk, Waldemar;Cozzi, Luca
通讯作者：
Cozzi, Luca
影响因子：
3.5
作者：
Nieder, C;Milas, L;Ang, KK
通讯作者：
Ang, KK
影响因子：
158.5
作者：
Sauer, R;Becker, H;Raab, R
通讯作者：
Raab, R
DOI：
10.1016/j.ijrobp.2016.07.033
发表时间：
2016-11-15
影响因子：
7
作者：
Craft, David;Khan, Fazal;Bortfeld, Thomas
通讯作者：
Bortfeld, Thomas