Proton Radiation Therapy Offers Reduced Normal Lung and Bone Marrow Exposure for Patients Receiving Dose-Escalated Radiation Therapy for Unresectable Stage III Non-Small-Cell Lung Cancer: A Dosimetric Study
Proton Radiation Therapy Offers Reduced Normal Lung and Bone Marrow Exposure for Patients Receiving Dose-Escalated Radiation Therapy for Unresectable Stage III Non-Small-Cell Lung Cancer: A Dosimetric Study
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DOI：
10.1016/j.cllc.2011.03.027
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发表时间：
2011-07-01
影响因子：
3.6
通讯作者：
Hoppe, Bradford S.
中科院分区：
文献类型：
--
作者：
Nichols, R. Charles;Huh, Soon N.;Hoppe, Bradford S.
简介：本研究的目的是确定质子放射治疗在不可切除的III期非小细胞肺癌患者中相对于光子放射治疗的潜在获益。材料与方法：使用相同的靶目标和正常组织约束，为8例连续的不可切除的III期非小细胞肺癌患者生成优化的三维适形光子（3DCRT）、调强放射治疗（IMRT）和质子治疗（PT）计划。比较了非靶向正常结构（包括肺、骨髓、食管、心脏和脊髓）的辐射暴露。光子剂量以灰度（戈伊）表示。质子剂量以钴灰当量（CGE）表示。结果：在所有患者中，3DCRT、IMRT和PT计划均达到了靶体积的剂量目标。与3DCRT计划相比，质子计划提供了正常肺V（20）戈伊（CGE）中位值减少29%，平均肺剂量（MLD）中位值减少33%，接受10戈伊剂量（CGE）的骨髓体积中位值减少30%。与调强放射治疗计划相比，质子计划提供了正常肺V（20）戈伊（CGE）中位值减少26%，MLD中位值减少31%，接受剂量为10戈伊（CGE）的骨髓体积中位值减少27%。结论：通过减少照射的正常结构的体积，质子可以潜在地提高接受联合放疗和化疗的不可切除的III期非小细胞肺癌患者的治疗指数。
Introduction: The purpose of this study was to determine the potential benefit of proton radiation therapy over photon radiation therapy in patients with unresectable stage III non-small-cell lung cancer. Materials and Methods: Optimized 3-dimensional conformal photon (3DCRT), intensity-modulated radiation therapy (IMRT) and proton therapy (PT) plans were generated for 8 consecutive patients with unresectable stage III non-small-cell lung cancer using the same target goals and normal tissue constraints. The radiation exposure to non-targeted normal structures, including lung, bone marrow, esophagus, heart, and spinal cord, were compared. Photon doses are expressed in gray (Gy). Proton doses are expressed in cobalt gray equivalents (CGE). Results: In all patients, 3DCRT, IMRT, and PT plans, achieved the dose goals for the target volumes. Compared with the 3DCRT plans, proton plans offered a median 29% reduction in normal lung V(20) Gy (CGE), a median 33% reduction in mean lung dose (MLD), and a median 30% reduction in the volume of bone marrow receiving a dose of 10 Gy (CGE). Compared with the IMRT plans, the proton plans offered a median 26% reduction in normal lung V(20) Gy (CGE), a median 31% reduction in MLD, and a median 27% reduction in the volume of bone marrow receiving a dose of 10 Gy (CGE). Conclusion: By reducing the volumes of normal structures irradiated, protons can potentially improve the therapeutic index for patients with unresectable stage III non-small-cell lung cancer receiving combined radiation therapy and chemotherapy.