Pro-con of proton: Dosimetric advantages of intensity-modulation over passive scatter for thoracic malignancies

Autor: Laure Marignol, Ang Wei Jie
Rok vydání: 2020
Předmět:
SFO
Single Field Optimisation
medicine.medical_treatment
030218 nuclear medicine & medical imaging
0302 clinical medicine
EUD
Equivalent Uniform Dose
Dose escalation
Interplay
HI
Homogeneity Index
Passively scattered proton therapy (PSPT)
iGTV/HU
Internal Gross Tumour Volume/Hounsfield Unit
Oncology (nursing)
Thoracic malignancies
Health Policy
PTV
Planning Target Volume
CT
Computed Tomography
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
PSPT
Passively Scattered Proton Therapy
IMRT
Intensity Modulated Radiation Therapy
030220 oncology & carcinogenesis
MU
Monitor Unit
Intensity modulation
Research Article
lcsh:Medical physics. Medical radiology. Nuclear medicine
DIBH
Deep Inspiration Breath-Hold
lcsh:R895-920
SFUD
Single Field Uniform Dose
MFO
Multi Field Optimisation
Dose distribution
lcsh:RC254-282
iCTV
Internal Clinical Target Volume
03 medical and health sciences
OAR
Organ-At-Risk
Dosimetry
RT
Radiation Therapy
medicine
Radiology
Nuclear Medicine and imaging
Care Planning
Proton therapy
NSCLC
Non-Small-Cell Lung cancer
ITV
Internal Target Volume
Monitor unit
Critical structure
business.industry
Intensity modulated proton therapy (IMPT)
Radiation therapy
BSPTV
Beam Specific Planning Target Volume
IMPT
Intensity Modulated Proton Therapy
business
Nuclear medicine
Organ at risks
Zdroj: Technical Innovations & Patient Support in Radiation Oncology
Technical Innovations & Patient Support in Radiation Oncology, Vol 15, Iss, Pp 37-46 (2020)
ISSN: 2405-6324
DOI: 10.1016/j.tipsro.2019.11.005
Popis: Highlights • Intensity Modulated Proton Therapy (IMPT) results in significant reduction of dose to organ at risk. • Improving plan robustness mitigates interplay effects. • Blanket use of small spots on a group of patients may severely worsen interplay in selected patients. • Hypofractionated regimes have fewer interplay effects in both fractional and overall simulations. • Randomised control trials are required before any clinical benefit of IMPT can be confirmed.
The use of passively scattered proton therapy (PSPT) or intensity modulated proton therapy (IMPT) opens the potential for dose escalation or critical structure sparing in thoracic malignancies. While the latter offers greater dose conformality, dose distributions are subjected to greater uncertainties, especially due to interplay effects. Exploration in this area is warranted to determine if there is any dosimetric advantages in using IMPT for thoracic malignancies. This review aims to both compare organs-at-risk sparing and plan robustness between PSPT and IMPT and examine the mitigation strategies for the reduction of interplay effects currently available. Early evidence suggests that IMPT is dosimetrically superior to PSPT in thoracic malignancies. Randomised control trials are required before any clinical benefit of IMPT can be confirmed.
Databáze: OpenAIRE
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