Intensity-Modulated Proton Therapy for Elective Nodal Irradiation and Involved-Field Radiation in the Definitive Treatment of Locally Advanced Non–Small-Cell Lung Cancer: A Dosimetric Study
| Autor: | Charles B. Simone, W O'Meara, Holly Ning, Ramesh Rengan, Karl Haglund, Christine J. Ko, Aparna H. Kesarwala, Eric Xanthopoulos |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Cancer Research Lung Neoplasms Nodal irradiation medicine.medical_treatment Locally advanced Article Carcinoma Non-Small-Cell Lung Proton Therapy medicine Humans Radiometry Lung cancer Proton therapy Aged business.industry Radiotherapy Dosage Middle Aged medicine.disease Tumor Burden Intensity (physics) Radiation therapy Oncology Total dose Feasibility Studies Female Lymph Nodes Radiotherapy Intensity-Modulated Non small cell Radiotherapy Conformal business Nuclear medicine |
| Zdroj: | Clinical Lung Cancer. 16:237-244 |
| ISSN: | 1525-7304 |
| DOI: | 10.1016/j.cllc.2014.12.001 |
| Popis: | Photon involved-field (IF) radiation therapy (IFRT), the standard for locally advanced (LA) non-small cell lung cancer (NSCLC), results in favorable outcomes without increased isolated nodal failures, perhaps from scattered dose to elective nodal stations. Because of the high conformality of intensity-modulated proton therapy (IMPT), proton IFRT could increase nodal failures. We investigated the feasibility of IMPT for elective nodal irradiation (ENI) in LA-NSCLC.IMPT IFRT plans were generated to the same total dose of 66.6-72 Gy received by 20 LA-NSCLC patients treated with photon IFRT. IMPT ENI plans were generated to 46 cobalt Gray equivalent (CGE) to elective nodal planning treatment volumes (PTV) plus 24 CGE to IF-PTVs.Proton IFRT and ENI improved the IF-PTV percentage of volume receiving 95% of the prescribed dose (D95) by 4% (P .01) compared with photon IFRT. All evaluated dosimetric parameters improved significantly with both proton plans. The lung percentage of volume receiving 20 Gy/CGE (V20) and mean lung dose decreased 18% (P .01) and 36% (P .01), respectively, with proton IFRT, and 11% (P = .03) and 26% (P .01) with ENI. The mean esophagus dose decreased 16% with IFRT and 12% with ENI; heart V25 decreased 63% with both (all P .01).This study demonstrates the feasibility of IMPT for LA-NSCLC ENI. Potential decreased toxicity indicates that IMPT could allow ENI while maintaining a favorable therapeutic ratio compared with photon IFRT. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect