Intensity-modulated radiotherapy of nasopharyngeal carcinoma: a comparative treatment planning study of photons and protons
Intensity-modulated radiotherapy of nasopharyngeal carcinoma: a comparative treatment planning study of photons and protons
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DOI：
10.1186/1748-717x-3-4
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发表时间：
2008-01-24
影响因子：
3.6
通讯作者：
Muenter, Marc W.
中科院分区：
文献类型：
--
作者：
Taheri-Kadkhoda, Zahra;Bjork-Eriksson, Thomas;Muenter, Marc W.
背景资料：本研究旨在探讨调强质子治疗（IMPT）与调强光子治疗（IMRT）在鼻咽癌（NPC）治疗中的潜在优势。原发性肿瘤（GTV-T）、GTV-T和转移性（PTV-TN）以及选择性（PTV-N）淋巴结站的大体肿瘤体积的钴格雷当量（GyE）剂量处方分别为72.6戈伊（E）、66戈伊（E）和52.8戈伊（E）。对每例患者，准备9个共面场IMRT步进-发射技术和3D点扫描3个共面场IMPT计划。这两种模式计划在33个部分，以提供一个同时集成的升压技术。所有计划的准备和优化，通过使用研究版本的逆治疗计划系统KonRad（DKFZ，海德堡）。结果：两种治疗技术是平等的平均剂量的目标体积。IMPT计划显著改善了肿瘤覆盖和形态（P < 0.05），并且将几个危及器官（OAR）的平均剂量降低了2-3倍。结论：在鼻咽癌放疗中，三野IMPT在肿瘤覆盖率、减少OAR和非特异性正常组织的累积剂量方面比九野IMRT有更大的潜力。IMPT在鼻咽癌中的实用性值得进一步探索，当这项技术在更广泛的临床规模。
Background: The aim of this treatment planning study was to investigate the potential advantages of intensity-modulated (IM) proton therapy (IMPT) compared with IM photon therapy (IMRT) in nasopharyngeal carcinoma (NPC).Methods: Eight NPC patients were chosen. The dose prescriptions in cobalt Gray equivalent (GyE) for gross tumor volumes of the primary tumor (GTV-T), planning target volumes of GTV-T and metastatic (PTV-TN) and elective (PTV-N) lymph node stations were 72.6 Gy(E), 66 Gy(E), and 52.8 Gy(E), respectively. For each patient, nine coplanar fields IMRT with step-and-shoot technique and 3D spot-scanned three coplanar fields IMPT plans were prepared. Both modalities were planned in 33 fractions to be delivered with a simultaneous integrated boost technique. All plans were prepared and optimized by using the research version of the inverse treatment planning system KonRad (DKFZ, Heidelberg).Results: Both treatment techniques were equal in terms of averaged mean dose to target volumes. IMPT plans significantly improved the tumor coverage and conformation (P < 0.05) and they reduced the averaged mean dose to several organs at risk (OARs) by a factor of 2-3. The low-to-medium dose volumes (0.33-13.2 Gy(E)) were more than doubled by IMRT plans.Conclusion: In radiotherapy of NPC patients, three-field IMPT has greater potential than nine-field IMRT with respect to tumor coverage and reduction of the integral dose to OARs and nonspecific normal tissues. The practicality of IMPT in NPC deserves further exploration when this technique becomes available on wider clinical scale.