Comparison of adverse effects of proton and X-ray chemoradiotherapy for esophageal cancer using an adaptive dose–volume histogram analysis
| Autor: | Takao Sekiguchi, Koichi Yamanashi, Hirokazu Makishima, Takayuki Hashimoto, Toshiyuki Okumura, Hideyuki Sakurai, Masashi Mizumoto, Hitoshi Ishikawa, Toshiyuki Terunuma, Takeji Sakae |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Dose-volume histogram Esophageal Neoplasms Health Toxicology and Mutagenesis X-Ray Therapy Lung injury concurrent chemoradiotherapy Proton Therapy medicine Humans Radiology Nuclear Medicine and imaging esophageal cancer Radiation Injuries Adverse effect Proton therapy Radiation Lung business.industry Radiotherapy Planning Computer-Assisted X-Rays Radiotherapy Dosage Chemoradiotherapy Lung Injury Middle Aged Esophageal cancer medicine.disease Tumor Burden proton beam therapy Treatment Outcome medicine.anatomical_structure Heart Injuries Oncology DVH analysis Data Interpretation Statistical Toxicity Female Radiology Protons deformation adaptation business Nuclear medicine |
| Zdroj: | Journal of Radiation Research |
| ISSN: | 1349-9157 0449-3060 |
| DOI: | 10.1093/jrr/rrv001 |
| Popis: | Cardiopulmonary late toxicity is of concern in concurrent chemoradiotherapy (CCRT) for esophageal cancer. The aim of this study was to examine the benefit of proton beam therapy (PBT) using clinical data and adaptive dose–volume histogram (DVH) analysis. The subjects were 44 patients with esophageal cancer who underwent definitive CCRT using X-rays (n = 19) or protons (n = 25). Experimental recalculation using protons was performed for the patient actually treated with X-rays, and vice versa. Target coverage and dose constraints of normal tissues were conserved. Lung V5–V20, mean lung dose (MLD), and heart V30–V50 were compared for risk organ doses between experimental plans and actual treatment plans. Potential toxicity was estimated using protons in patients actually treated with X-rays, and vice versa. Pulmonary events of Grade ≥2 occurred in 8/44 cases (18%), and cardiac events were seen in 11 cases (25%). Risk organ doses in patients with events of Grade ≥2 were significantly higher than for those with events of Grade ≤1. Risk organ doses were lower in proton plans compared with X-ray plans. All patients suffering toxicity who were treated with X-rays (n = 13) had reduced predicted doses in lung and heart using protons, while doses in all patients treated with protons (n = 24) with toxicity of Grade ≤1 had worsened predicted toxicity with X-rays. Analysis of normal tissue complication probability showed a potential reduction in toxicity by using proton beams. Irradiation dose, volume and adverse effects on the heart and lung can be reduced using protons. Thus, PBT is a promising treatment modality for the management of esophageal cancer. |
| Databáze: | OpenAIRE |
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