Dosimetric comparison study between intensity modulated radiation therapy and three-dimensional conformal proton therapy for pelvic bone marrow sparing in the treatment of cervical cancer

Autor: Loren K. Mell, G. White, Arno J. Mundt, W. Tyler Watkins, R. Charles Nichols, Y. Liang, William Y. Song, Soon Huh
Rok vydání: 2010
Předmět:
cervical cancer
medicine.medical_treatment
Radiotherapy Planning
Medical Physiology
Uterine Cervical Neoplasms
Bragg peak
Cervical Cancer
Imaging
Computer-Assisted
Bone Marrow
Intensity-Modulated
Proton Therapy
proton therapy
pelvic bone marrow
Instrumentation
Cancer
Cervical cancer
Radiation
Conformal
Radiotherapy Dosage
Other Physical Sciences
Nuclear Medicine & Medical Imaging
medicine.anatomical_structure
DVH analysis
Female
Urologic Diseases
Clinical Sciences
Imaging
Three-Dimensional
Clinical Research
medicine
Humans
Radiation Oncology Physics
Radiology
Nuclear Medicine and imaging
IMRT
Pelvic Bones
Proton therapy
Radiotherapy
business.industry
Radiotherapy Planning
Computer-Assisted
Intensity-modulated radiation therapy
medicine.disease
Conformity index
Radiation therapy
Three-Dimensional
Comparison study
Radiotherapy
Intensity-Modulated
Bone marrow
Radiotherapy
Conformal
business
Nuclear medicine
Zdroj: Journal of Applied Clinical Medical Physics
Journal of applied clinical medical physics, vol 11, iss 4
ISSN: 1526-9914
Popis: The objective was to compare intensity‐modulated radiation therapy (IMRT) with 3D conformal proton therapy (3DCPT) in the treatment of cervical cancer. In particular, each technique's ability to spare pelvic bone marrow (PBM) was of primary interest in this study. A total of six cervical cancer patients (3 postoperative and 3 intact) were planned and analyzed. All plans had uniform 1.0 cm CTV‐PTV margin and satisfied the 95% PTV with 100% isodose (prescription dose=45Gy) coverage. Dose‐volume histograms (DVH) were analyzed for comparison. The overall PTV and PBM volumes were 1035.9±192.2 cc and 1151.4±198.3 cc, respectively. In terms of PTV dose conformity index (DCI) and dose homogeneity index (DHI), 3DCPT was slightly superior to IMRT with 1.00±0.001,1.01±0.02, and 1.10±0.02,1.13±0.01, respectively. In addition, 3DCPT demonstrated superiority in reducing lower doses (i.e., V30 or less) to PBM, small bowel and bladder. Particularly in PBM, average V10 and V20 reductions of 10.8% and 7.4%(p=0.001 and 0.04), respectively, were observed. However, in the higher dose range, IMRT provided better sparing (>V30). For example, in small bowel and PBM, average reductions in V45 of 4.9% and 10.0%(p=0.048 and 0.008), respectively, were observed. Due to its physical characteristics such as low entrance dose, spread‐out Bragg peak and finite particle range of protons, 3DCPT illustrated superior target coverage uniformity and sparing of the lower doses in PBM and other organs. Further studies are, however, needed to fully exploit the benefits of protons for general use in cervical cancer. PACS number: 87.55.D‐, 87.55.dk
Databáze: OpenAIRE
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