Dosimetric comparison of intensity modulated radiotherapy and intensity modulated proton therapy in the treatment of recurrent nasopharyngeal carcinoma

医学 质子疗法 核医学 鼻咽癌 放射治疗 放射治疗计划 强度调制 剂量学 放射科 相(物质) 相位调制 有机化学 化学
作者
Hing Ming Hung,Oliver Cheuk Ming Chan,Chi Hang Christopher Mak,Wai Man Hung,Wai Tong Ng,Michael Chi Hang Lee
出处
期刊:Medical Dosimetry [Elsevier BV]
卷期号:47 (1): 14-19 被引量:7
标识
DOI:10.1016/j.meddos.2021.07.002
摘要

To compare the dosimetric performance of Intensity Modulated Proton Therapy (IMPT) and Intensity Modulated Radiotherapy (IMRT) in terms of target volume coverage and sparing of neurological organs-at-risk (OARs) in salvaging recurrent nasopharyngeal carcinoma (rNPC). The maximum dose to the internal carotid artery (ICA) and nasopharyngeal (NP) mucosa, which are associated with potential carotid blowout and massive epistaxis, were also evaluated.IMRT and IMPT treatment plans were created for twenty patients with locally advanced rNPC. Planning Target Volume (PTV) was used to account for the setup and spatial error/uncertainty in the IMRT planning. Robust optimization on Clinical Target Volume (CTV) coverage with consideration of range and setup uncertainty was employed to produce two IMPT plans with 3-field and 4-field arrangements. The planning objective was to deliver 60 Gy to the PTV (IMRT) and CTV (IMPT) without exceeding the maximum lifetime cumulative Biologically Effective Dose (BED) of the neurological OARs (applied to the Planning organs-at-risk volume). The target dose coverage as well as the maximum dose to the neurological OARs, ICA, and NP mucosa were compared.Compared with IMRT, 3-field IMPT achieved better coverage to GTV V100% (83.3% vs. 73.2%, P <0.01) and CTV V100% (80.5% vs. 72.4%, P <0.01), and lower maximum dose to the critical OARs including the spinal cord (19.2 Gy vs. 22.3 Gy, P <0.01), brainstem (30.0 Gy vs. 32.3 Gy, P <0.01) and optic chiasm (6.6 Gy vs. 9.8 Gy, P <0.01). The additional beam with the 4-fields IMPT plans further improved the target coverage from the 3-field IMPT (CTV V98%: 85.3% vs. 82.4%, P <0.01) with similar OAR sparing. However, the target dose was highly non-uniform with both IMPT plans, leading to a significantly higher maximum dose to the ICA (∼68 Gy vs. 62.6 Gy, P <0.01) and NP mucosa (∼72 Gy vs. 62.8 Gy, P <0.01) than IMRT.IMPT demonstrated some dosimetric advantage over IMRT in treating rNPC. However, IMPT could also result in very high dose hot spots in the target volume. Careful consideration of the ICA and NP mucosal complications is recommended when applying IMPT on rNPC patients.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
深海鱼发布了新的文献求助30
1秒前
朱建军应助Ariesfei采纳,获得10
1秒前
鉴定为学计算学的完成签到,获得积分10
2秒前
xj305发布了新的文献求助10
3秒前
斯文败类应助勤奋的丸子采纳,获得10
3秒前
5秒前
辉辉发布了新的文献求助10
5秒前
6秒前
9秒前
海皇星空完成签到 ,获得积分10
9秒前
恒浚完成签到,获得积分10
10秒前
搞怪含巧完成签到,获得积分10
10秒前
王俞关注了科研通微信公众号
10秒前
热心不凡完成签到,获得积分10
11秒前
lqh完成签到,获得积分20
11秒前
13秒前
13秒前
13秒前
哈哈哈发布了新的文献求助10
13秒前
faye发布了新的文献求助10
14秒前
hhsong完成签到,获得积分10
14秒前
勤奋酒窝完成签到,获得积分10
16秒前
roser发布了新的文献求助10
16秒前
几星霜完成签到,获得积分10
17秒前
lin应助李子采纳,获得10
17秒前
Y垚发布了新的文献求助10
18秒前
zhige发布了新的文献求助30
19秒前
还不错的橙子完成签到,获得积分10
20秒前
鲨鱼牙齿关注了科研通微信公众号
21秒前
情怀应助苏叶采纳,获得10
21秒前
22秒前
跳跃太清完成签到 ,获得积分10
22秒前
科目三应助guojin采纳,获得10
23秒前
25秒前
26秒前
pluto应助淡然的铭采纳,获得10
27秒前
27秒前
我是老大应助roser采纳,获得10
28秒前
SciGPT应助有魅力向珊采纳,获得10
28秒前
呱呱乐发布了新的文献求助30
29秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3969557
求助须知:如何正确求助?哪些是违规求助? 3514377
关于积分的说明 11173836
捐赠科研通 3249692
什么是DOI,文献DOI怎么找? 1794979
邀请新用户注册赠送积分活动 875537
科研通“疑难数据库(出版商)”最低求助积分说明 804836