Potential reduction of the incidence of radiation-induced second cancers by using proton beams in the treatment of pediatric tumors
Potential reduction of the incidence of radiation-induced second cancers by using proton beams in the treatment of pediatric tumors
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DOI：
10.1016/s0360-3016(02)02982-6
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发表时间：
2002-11-01
影响因子：
7
通讯作者：
Schneider, U
中科院分区：
文献类型：
--
作者：
Miralbell, R;Lomax, A;Schneider, U
目的：为了评估与常规或强度调制（IM）的X射线束治疗引起的继发性癌症在儿科oncology.Methods和材料的发病率相比，质子束的剂量分布改善的潜在影响：两个孩子，一个脑膜旁横纹肌肉瘤（RMS）和第二个髓母细胞瘤，被用作本研究的目的模型。在确定目标和关键结构后，计算并优化治疗计划，其中四种用于RMS病例（常规X射线、IM X射线、质子和IM质子），三种用于髓母细胞瘤中脊髓轴的照射（常规X射线、IM X射线、质子）。使用基于国际放射防护委员会第60号出版物的模型估计继发性癌症发病率。该模型允许估计的绝对风险的继发性癌症的每一个治疗计划的基础上的剂量体积distributions为nontarget organs.Results：质子束减少了预期的发病率辐射诱导继发性癌症的RMS患者的一个因素大于或等于2和髓母细胞瘤的情况下的一个因素8至15时相比，无论是IM或传统的X射线计划。在儿童和青少年RMS和MBD治疗中使用质子束（前向计划或IM）后，儿童癌症继发性癌症的可能性显著降低，这是支持质子治疗在儿童肿瘤学中大多数放射治疗适应症的发展的另一个论据。(C)2002年爱思唯尔科学公司
Purpose: To assess the potential influence of improved dose distribution with proton beams compared to conventional or intensity-modulated (IM) X-ray beams on the incidence of treatment-induced secondary cancers in pediatric oncology.Methods and Materials: Two children, one with a parameningeal rhabdomyosarcoma (RMS) and a second with a medulloblastoma, were used as models for the purpose of this study. After defining the target and critical structures, treatment plans were calculated and optimized, four for the RMS case (conventional X-ray, IM X-rays, protons, and IM protons) and three for the irradiation of the spinal axis in medulloblastoma (conventional X-ray, IM X-rays, protons). Secondary cancer incidence was estimated using a model based on Publication No. 60 of the International Commission on Radiologic Protection. This model allowed estimation of absolute risks of secondary cancer for each treatment plan based on dose-volume distributions for the nontarget organs.Results: Proton beams reduced the expected incidence of radiation-induced secondary cancers for the RMS patient by a factor of greater than or equal to2 and for the medulloblastoma case by a factor of 8 to 15 when compared with either IM or conventional X-ray plans.Conclusions: The potential for a significant reduction in secondary cancers with pediatric cancers after using proton beams (forward planned or IM) in the treatment of RMS and MBD in children and adolescents represents an additional argument supporting the development of proton therapy for most radiotherapy indications in pediatric oncology. (C) 2002 Elsevier Science Inc.