Significant reduction of normal tissue dose by proton radiotherapy compared with three-dimensional conformal or intensity-modulated radiation therapy in Stage I or Stage III non-small-cell lung cancer
Significant reduction of normal tissue dose by proton radiotherapy compared with three-dimensional conformal or intensity-modulated radiation therapy in Stage I or Stage III non-small-cell lung cancer
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DOI：
10.1016/j.ijrobp.2006.01.052
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发表时间：
2006-07-15
影响因子：
7
通讯作者：
Cox, James D.
中科院分区：
文献类型：
--
作者：
Chang, Joe Y.;Zhang, Xiaodong;Cox, James D.
目的：比较光子与质子放射治疗非小细胞肺癌（NSCLC）患者的剂量-体积直方图（DVH）。方法与材料：比较3维适形放射治疗（3D-CRT）、调强放射治疗（IMRT）和质子治疗方案的剂量-体积直方图，1期剂量分别为66 Gy、87.5 Gy （n = 10）、60-63 Gy、74 Gy （n = 15）。结果：对于第一阶段，66 Gy光子3D-CRT的平均总肺V5， V10和V20分别为31.8%，24.6%和15.8%，而质子剂量增加到87.5钴灰色当量（CGE）时分别为13.4%，12.3%和10.9% （p = 0.002）。对于111期，63 Gy光子3D-CRT的平均总肺V5， V10和V20分别为54.1%，46.9%和34.8%，而质子剂量增加到74 CGE的平均总肺V5， V10和V20分别为39.7%，36.6%和31.6% （p = 0.002）。在所有病例中，质子治疗对肺、脊髓、心脏、食道的剂量和整体剂量甚至比IMRT更低。结论：与标准剂量光子治疗相比，无论是3D-CRT还是IMRT，质子治疗似乎可以显著减少正常组织的剂量，即使剂量增加。(c) 2006爱思唯尔公司
Purpose: To compare dose-volume histograms (DVH) in patients with non-small-cell lung cancer (NSCLC) treated by photon or proton radiotherapy.Methods and Materials: Dose-volume histograms were compared between photon, including three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and proton plans at doses of 66 Gy, 87.5 Gy in Stage 1 (n = 10) and 60-63 Gy, and 74 Gy in Stage III (n = 15).Results: For Stage 1, the mean total lung V5, V10, and V20 were 31.8%, 24.6%, and 15.8%, respectively, for photon 3D-CRT with 66 Gy, whereas they were 13.4%, 12.3%, and 10.9%, respectively, with proton with dose escalation to 87.5 cobalt Gray equivalents (CGE) (p = 0.002). For Stage 111, the mean total lung V5, V10, and V20 were 54.1%, 46.9%, and 34.8%, respectively, for photon 3D-CRT with 63 Gy, whereas they were 39.7%, 36.6%, and 31.6%, respectively, for proton with dose escalation to 74 CGE (p = 0.002). In all cases, the doses to lung, spinal cord, heart, esophagus, and integral dose were lower with proton therapy even compared with IMRT.Conclusions: Proton treatment appears to reduce dose to normal tissues significantly, even with dose escalation, compared with standard-dose photon therapy, either 3D-CRT or IMRT. (c) 2006 Elsevier Inc.