Comparative treatment planning between proton and x-ray therapy in esophageal cancer
Comparative treatment planning between proton and x-ray therapy in esophageal cancer
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DOI：
10.1016/s0360-3016(98)00047-9
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发表时间：
1998-05-01
影响因子：
7
通讯作者：
Glimelius, B
中科院分区：
文献类型：
--
作者：
Isacsson, U;Lennernäs, B;Glimelius, B
目的：本文对5例食管癌患者进行了兆伏级X线和质子的适形治疗计划研究，以确定质子替代X线的优点。方法和材料：对5例患者分别制定了两种不同的质子计划、一种X线计划和一种X线和质子混合计划。使用三维治疗计划系统TMS（TM）。应用Nahum和Webb提出的肿瘤控制概率（TCP）模型和莱曼提出的正常组织并发症（NTCP）模型，对不同方案的剂量分布进行了剂量-体积直方图（DVH）评价。有风险的剂量限制器官是脊髓、肺和心脏，但质子计划也比a射线计划更好地保护肾脏。在任何风险器官中NTCP为5%的情况下，与仅使用X射线相比，使用最佳质子计划时，5名患者的计算平均TCP值平均增加20%单位（从2到23%单位）。然而，如果我们假设脊髓中的最大风险为1%，两个肺的总NTCP为100%，则与仅X射线相比，使用最佳质子计划的5名患者的平均TCP值从6%增加到49%。相应的数字为混合计划是27%，这些收益是相对不敏感的变化在合理的范围内的生物学parameters.Conclusions：质子出现了明显的治疗优势，传统的外放射治疗食管癌时。(C)1998年爱思唯尔科学公司
Purpose: Conformal treatment planning with megavoltage x-rays and protons for five patients with esophageal cancer has been studied in arl attempt to determine if there are advantages of using protons instead of x-rays.Methods and Materials: For each of the five patients, two different proton plans, one x-ray plan, and one mixed plan with x-rays and protons were made. A three-dimensional treatment planning system, TMS(TM), was used. The evaluation of the different plans was made by applying the tumor control probability (TCP) model proposed by Nahum and Webb and the normal tissue complication (NTCP) model proposed by Lyman on the dose distributions in terms of dose-volume histograms (DVHs),Results: The comparison shows advantages Of using protons instead of x-rays for all five patients. The dose-limiting organs at risk are the spinal cord, the lungs, and the heart, but the proton plans also spare the kidneys better than the a-ray plan doles. At 5% NTCP in any risk organ, the calculated mean TCP value for the five patients is increased by an average of 20%-units (from 2 to 23%-units) with the best proton plan compared with x-rays only. However, if we assume maximally a 1% risk in the spinal cord and a total NTCP for the two lungs of 100%, the mean TCP value for the five patients is increased from 6 to 49% with the best proton plan compared with x-rays only. The corresponding figure for the mixed plan is 27%, These gains are relatively insensitive to variations within reasonable limits in the biological parameters.Conclusions: Protons appear to have clear therapeutic advantages over conventional external radiotherapy when treating esophageal carcinoma. (C) 1998 Elsevier Science Inc.