Managing treatment-related uncertainties in proton beam radiotherapy for gastrointestinal cancers.
| Autor: | Tryggestad EJ; Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, USA., Liu W; Department of Radiation Oncology, Mayo Clinic Phoenix, Phoenix, AZ, USA., Pepin MD; Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, USA., Hallemeier CL; Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, USA., Sio TT; Department of Radiation Oncology, Mayo Clinic Phoenix, Phoenix, AZ, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of gastrointestinal oncology [J Gastrointest Oncol] 2020 Feb; Vol. 11 (1), pp. 212-224. |
| DOI: | 10.21037/jgo.2019.11.07 |
| Abstrakt: | In recent years, there has been rapid adaption of proton beam radiotherapy (RT) for treatment of various malignancies in the gastrointestinal (GI) tract, with increasing number of institutions implementing intensity modulated proton therapy (IMPT). We review the progress and existing literature regarding the technical aspects of RT planning for IMPT, and the existing tools that can help with the management of uncertainties which may impact the daily delivery of proton therapy. We provide an in-depth discussion regarding range uncertainties, dose calculations, image guidance requirements, organ and body cavity filling consideration, implanted devices and hardware, use of fiducials, breathing motion evaluations and both active and passive motion management methods, interplay effect, general IMPT treatment planning considerations including robustness plan evaluation and optimization, and finally plan monitoring and adaptation. These advances have improved confidence in delivery of IMPT for patients with GI malignancies under various scenarios. Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare. (2020 Journal of Gastrointestinal Oncology. All rights reserved.) |
| Databáze: | MEDLINE |
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