Optimization of carbon ion and proton treatment plans using the raster-scanning technique for patients with unresectable pancreatic cancer.
Optimization of carbon ion and proton treatment plans using the raster-scanning technique for patients with unresectable pancreatic cancer.
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DOI：
10.1186/s13014-015-0538-x
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发表时间：
2015-11-21
期刊：
影响因子：
--
通讯作者：
Combs SE
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文献类型：
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作者：
Dreher C;Habermehl D;Ecker S;Brons S;El-Shafie R;Jäkel O;Debus J;Combs SE
本论文的目的是通过使用碳离子和质子束来改进局部晚期、不能切除的胰腺癌患者的放射计划。使用治疗计划系统Syngo RT Planning（Siemens，埃尔兰根，德国），为5名患者创建了总计50个治疗计划，剂量计划为15 × 3戈伊（RBE）。根据解剖结构，认为5种射野配置相关。分析计划的剂量分布和个体解剖结构，并使用定制的指数进行比较。在该指数内，三场配置产生了最好的结果，尽管具有多种得分（场设置5，碳离子：中值74（范围48-101））。髓核中的最大剂量较低（例如病例3，碳离子：21.5戈伊（RBE））。单个后野通常可避免危及器官，但髓核中的最大剂量很高（例如病例3，碳离子：32.9戈伊（RBE））。两个斜后方野导致髓内可接受的最大剂量（例如，病例3，碳离子：26.9戈伊（RBE））。单视野配置和两个斜后方视野的评分离散度较小（碳离子：中位数66和58（范围62-72和40-69））。在危险器官与靶体积的地形接近的情况下，单视野配置和三视野配置都进行了评分。总之，三射野配置显示出最佳剂量分布。在地形条件困难和器官在地形上接近靶体积的情况下，单个后野似乎是稳健和有益的。具有两个倾斜后野的设置是三野和单野配置之间的合理折衷。
The aim of the thesis is to improve radiation plans of patients with locally advanced, unresectable pancreatic cancer by using carbon ion and proton beams. Using the treatment planning system Syngo RT Planning (Siemens, Erlangen, Germany) a total of 50 treatment plans have been created for five patients with the dose schedule 15 × 3 Gy(RBE). With reference to the anatomy, five field configurations were considered to be relevant. The plans were analyzed with respect to dose distribution and individual anatomy, and compared using a customized index. Within the index the three-field configurations yielded the best results, though with a high variety of score points (field setup 5, carbon ion: median 74 (range 48–101)). The maximum dose in the myelon is low (e.g. case 3, carbon ion: 21.5 Gy(RBE)). A single posterior field generally spares the organs at risk, but the maximum dose in the myelon is high (e.g. case 3, carbon ion: 32.9 Gy(RBE)). Two oblique posterior fields resulted in acceptable maximum doses in the myelon (e.g. case 3, carbon ion: 26.9 Gy(RBE)). The single-field configuration and the two oblique posterior fields had a small score dispersion (carbon ion: median 66 and 58 (range 62–72 and 40–69)). In cases with topographic proximity of the organs at risk to the target volume, the single-field configuration scored as well as the three-field configurations. In summary, the three-field configurations showed the best dose distributions. A single posterior field seems to be robust and beneficial in case of difficult topographical conditions and topographical proximity of organs at risk to the target volume. A setup with two oblique posterior fields is a reasonable compromise between three-field and single-field configurations.