Cardiac-Sparing and Breast-Sparing Whole Lung Irradiation Using Intensity-Modulated Proton Therapy
| Autor: | Austin M. Faught, Matthew J. Krasin, Sahaja Acharya, Jacqueline Faught, Melissa Gargone, Ru Xin Wong, William Myers |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
lcsh:R895-920 Left atrium Planning target volume cardiac-sparing 030218 nuclear medicine & medical imaging Right breast 03 medical and health sciences 0302 clinical medicine whole lung irradiation medicine proton therapy lcsh:Nuclear and particle physics. Atomic energy. Radioactivity Radiology Nuclear Medicine and imaging Proton therapy breast-sparing business.industry Original Articles Whole lung irradiation Atomic and Molecular Physics and Optics Intensity (physics) Left breast medicine.anatomical_structure 030220 oncology & carcinogenesis lcsh:QC770-798 Right atrium Nuclear medicine business |
| Zdroj: | International Journal of Particle Therapy International Journal of Particle Therapy, Vol 7, Iss 4, Pp 65-73 (2021) |
| ISSN: | 2331-5180 |
| Popis: | Purpose Whole lung irradiation (WLI) is indicated for certain pediatric patients with lung metastases. This study investigated whether WLI delivered as intensity-modulated proton therapy (IMPT) could significantly spare the heart and breasts when compared with conventional WLI delivered with anteroposterior/posteroanterior photon fields and with intensity-modulated photon therapy (IMRT) WLI. Materials and Methods Conventional, IMRT, and IMPT plans were generated for 5 patients (aged 5-22 years). The prescription dose was 16.5 GyRBE in 1.5-GyRBE fractions. Conventional plans used 6-MV photons prescribed to the midline and a field-in-field technique to cover the planning target volume (the internal target volume [ITV] + 1 cm). IMRT plans used 6-MV photons with a 7-beam arrangement with dose prescribed to the planning target volume. IMPT plans used scenario-based optimization with 5% range uncertainty and 5-mm positional uncertainty to cover the ITV robustly. Monte Carlo dose calculation was used for all IMPT plans. Doses were compared with paired Student t test. Results The ITV Dmean was similar for the IMPT, conventional, and IMRT plans, but the IMPT plans had a lower Dmin and a higher Dmax at tissue interfaces than conventional plans (Dmean ratio: 0.96, P > .05; Dmin ratio: 0.9, P Conclusions IMPT resulted in comparable ITV coverage and lower mean doses to the heart and breasts when compared with other techniques. Whole lung irradiation delivered as IMPT warrants prospective evaluation in pediatric patients. |
| Databáze: | OpenAIRE |
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