Proton radiation therapy for retinoblastoma: Comparison of various intraocular tumor locations and beam arrangements
- Department of Radiotherapy, University of Piemonte Orientale, Novara (Italy)
- Department of Radiation Oncology, Dartmouth Hitchcock Medical Center, Lebanon, NH (United States)
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)
- Department of Radiation Physics, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)
Purpose: To study the optimization of proton beam arrangements for various intraocular tumor locations; and to correlate isodose distributions with various target and nontarget structures. Methods and materials: We considered posterior-central, nasal, and temporal tumor locations, with straight, intrarotated, or extrarotated eye positions. Doses of 46 cobalt grey equivalent (CGE) to gross tumor volume (GTV) and 40 CGE to clinical target volume (CTV) (2 CGE per fraction) were assumed. Using three-dimensional planning, we compared isodose distributions for lateral, anterolateral oblique, and anteromedial oblique beams and dose-volume histograms of CTVs, GTVs, lens, lacrimal gland, bony orbit, and soft tissues. Results: All beam arrangements fully covered GTVs and CTVs with optimal lens sparing. Only 15% of orbital bone received doses {>=}20 CGE with a lateral beam, with 20-26 CGE delivered to two of three growth centers. The anterolateral oblique approach with an intrarotated eye resulted in additional reduction of bony volume and exposure of only one growth center. No appreciable dose was delivered to the contralateral eye, brain tissue, or pituitary gland. Conclusions: Proton therapy achieved homogeneous target coverage with true lens sparing. Doses to orbit structures, including bony growth centers, were minimized with different beam arrangements and eye positions. Proton therapy could reduce the risks of second malignancy and cosmetic and functional sequelae.
- OSTI ID:
- 20633067
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 61, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2004.06.003; PII: S0360-3016(04)00963-0; Copyright (c) 2005 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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