Advantage of protons compared to conventional X-ray or IMRT in the treatment of a pediatric patient with medulloblastoma
Advantage of protons compared to conventional X-ray or IMRT in the treatment of a pediatric patient with medulloblastoma
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DOI：
10.1016/s0360-3016(03)01574-8
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发表时间：
2004-03-01
影响因子：
7
通讯作者：
Tarbell, NJ
中科院分区：
文献类型：
--
作者：
St Clair, WH;Adams, JA;Tarbell, NJ
目的：比较治疗计划从标准的光子治疗的强度调制X射线（IMRT）和质子的颅脊髓轴照射和后颅窝助推在patient with mythloblastoma.Methods：质子计划完成使用内部的三维规划系统。IMRT计划开发使用KonRad治疗计划系统与6 MV photons.Results：大量的正常组织的剂量节省实现了IMRT和质子治疗的后颅窝和脊柱。例如，对90%耳蜗的剂量从常规X射线的规定后颅窝增强剂量的101.2%分别减少到IMRT和质子的33.4%和2.4%。心脏体积50%的剂量从传统X射线的72.2%减少到IMRT的29.5%和质子的0.5%。长期的毒性，重点是听力和内分泌和心脏功能，应大大改善继发于非靶组织保留实现与proton.Conclusion：本研究清楚地表明了适形放射治疗的优势，后颅窝和脊柱髓母细胞瘤的儿童相比，传统的X射线。在评价的两种适形治疗方法中，质子被认为是上级调强放疗。(C)2004年爱思唯尔公司
Purpose: To compare treatment plans from standard photon therapy to intensity modulated X-rays (IMRT) and protons for craniospinal axis irradiation and posterior fossa boost in a patient with medulloblastoma.Methods: Proton planning was accomplished using an in-house 3D planning system. IMRT plans were developed using the KonRad treatment planning system with 6-MV photons.Results: Substantial normal-tissue dose sparing was realized with IMRT and proton treatment of the posterior fossa and spinal column. For example, the dose to 90% of the cochlea was reduced from 101.2% of the prescribed posterior fossa boost dose from conventional X-rays to 33.4% and 2.4% from IMRT and protons, respectively. Dose to 50% of the heart volume was reduced from 72.2% for conventional X-rays to 29.5% for IMRT and 0.5% for protons. Long-term toxicity with emphasis on hearing and endocrine and cardiac function should be substantially improved secondary to nontarget tissue sparing achieved with protons.Conclusion: The present study clearly demonstrates the advantage of conformal radiation methods for the treatment of posterior fossa and spinal column in children with medulloblastoma, when compared to conventional X-rays. Of the two conformal treatment methods evaluated, protons were found to be superior to IMRT. (C) 2004 Elsevier Inc.