Comparison of dose-volume histograms between proton beam and X-ray conformal radiotherapy for locally advanced non-small-cell lung cancer.
Comparison of dose-volume histograms between proton beam and X-ray conformal radiotherapy for locally advanced non-small-cell lung cancer.
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DOI：
10.1093/jrr/rru082
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发表时间：
2015-01
影响因子：
2
通讯作者：
Sakurai H
中科院分区：
文献类型：
--
作者：
Ohno T;Oshiro Y;Mizumoto M;Numajiri H;Ishikawa H;Okumura T;Terunuma T;Sakae T;Sakurai H
本研究的目的是比较局部晚期非小细胞肺癌（NSCLC）质子束治疗（PBT）和X线适形放疗（XCRT）的剂量体积直方图（DVH）参数，根据肿瘤的情况。本分析共入组了35例接受PBT治疗的NSCLC患者。TNM分期和淋巴结状态分别为IIB（n = 3）、IIIA（n = 15）和IIIB（n = 17）; N 0（n = 2）、N1（n = 4）、N2（n = 17）和N3（n = 12）。基于相同的CT模拟XCRT计划，并基于实际PBT计划使用相同的临床靶体积（CTV）。原发部位的治疗剂量为74 Gy当量剂量（GyE），阳性淋巴结的治疗剂量为66 Gy。根据正常肺剂量计算各参数，比较各剂量组的照射体积（Vx）。根据V5 ≥ 42%，V20 ≥ 25%，平均肺剂量≥ 20戈伊的标准评价两种方案的可行性。PBT的平均正常肺剂量和V5至V50显著低于XCRT。随着淋巴结状态的进展和CTV的增大，差异更大。此外，根据标准，45.7%的X射线计划被归类为不适当，而17.1%的质子计划被认为是不适当的。在淋巴结分期较晚的病例中，X线计划不充分的数量增加。这项研究表明，一些不能接受光子放射治疗的患者可以使用PBT进行治疗。
The purpose of this study was to compare the parameters of the dose–volume histogram (DVH) between proton beam therapy (PBT) and X-ray conformal radiotherapy (XCRT) for locally advanced non-small-cell lung cancer (NSCLC), according to the tumor conditions. A total of 35 patients having NSCLC treated with PBT were enrolled in this analysis. The numbers of TNM stage and lymph node status were IIB (n = 3), IIIA (n = 15) and IIIB (n = 17), and N0 (n = 2), N1 (n = 4), N2 (n = 17) and N3 (n = 12), respectively. Plans for XCRT were simulated based on the same CT, and the same clinical target volume (CTV) was used based on the actual PBT plan. The treatment dose was 74 Gy-equivalent dose (GyE) for the primary site and 66 GyE for positive lymph nodes. The parameters were then calculated according to the normal lung dose, and the irradiation volumes of the doses (Vx) were compared. We also evaluated the feasibility of both plans according to criteria: V5 ≥ 42%, V20 ≥ 25%, mean lung dose ≥ 20 Gy. The mean normal lung dose and V5 to V50 were significantly lower in PBT than in XCRT. The differences were greater with the more advanced nodal status and with the larger CTV. Furthermore, 45.7% of the X-ray plans were classified as inadequate according to the criteria, whereas 17.1% of the proton plans were considered unsuitable. The number of inadequate X-ray plans increased in cases with advanced nodal stage. This study indicated that some patients who cannot receive photon radiotherapy may be able to be treated using PBT.