Small‐spot intensity‐modulated proton therapy and volumetric‐modulated arc therapies for patients with locally advanced non‐small‐cell lung cancer: A dosimetric comparative study

Autor: Wei Liu, Chenbin Liu, Steven E. Schild, Wei Deng, Thomas B. Daniels, Jiajian Shen, Terence T. Sio, Xiaoning Ding, William G. Rule, Martin Bues, Shawn Korte, Pedro Lara, Jie Shan
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Lung Neoplasms
Locally advanced
Planning target volume
interplay effects
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Carcinoma
Non-Small-Cell Lung
Proton Therapy
Medicine
Radiation Oncology Physics
Humans
Radiology
Nuclear Medicine and imaging
Stage (cooking)
volumetric‐modulated arc therapy
Lung cancer
Radiometry
Instrumentation
Proton therapy
87.50.cm
Aged
Retrospective Studies
Aged
80 and over
Radiation
business.industry
Radiotherapy Planning
Computer-Assisted
Spot intensity
Radiotherapy Dosage
Middle Aged
medicine.disease
Prognosis
Volumetric modulated arc therapy
3. Good health
lung cancer
030220 oncology & carcinogenesis
Female
Non small cell
Radiotherapy
Intensity-Modulated
business
Nuclear medicine
intensity‐modulated proton therapy
Follow-Up Studies
Zdroj: Journal of Applied Clinical Medical Physics
ISSN: 1526-9914
Popis: Purpose To compare dosimetric performance of volumetric-modulated arc therapy (VMAT) and small-spot intensity-modulated proton therapy for stage III non-small-cell lung cancer (NSCLC). Methods and materials A total of 24 NSCLC patients were retrospectively reviewed; 12 patients received intensity-modulated proton therapy (IMPT) and the remaining 12 received VMAT. Both plans were generated by delivering prescription doses to clinical target volumes (CTV) on averaged 4D-CTs. The dose-volume-histograms (DVH) band method was used to quantify plan robustness. Software was developed to evaluate interplay effects with randomized starting phases of each field per fraction. DVH indices were compared using Wilcoxon rank sum test. Results Compared with VMAT, IMPT delivered significantly lower cord Dmax , heart Dmean , and lung V5 Gy[ RBE ] with comparable CTV dose homogeneity, and protection of other OARs. In terms of plan robustness, the IMPT plans were statistically better than VMAT plans in heart Dmean , but were statistically worse in CTV dose coverage, cord Dmax , lung Dmean , and V5 Gy[ RBE ] . Other DVH indices were comparable. The IMPT plans still met the standard clinical requirements with interplay effects considered. Conclusions Small-spot IMPT improves cord, heart, and lung sparing compared to VMAT and achieves clinically acceptable plan robustness at least for the patients included in this study with motion amplitude less than 11 mm. Our study supports the usage of IMPT to treat some lung cancer patients.
Databáze: OpenAIRE
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