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Title: Proton Stereotactic Body Radiation Therapy for Clinically Challenging Cases of Centrally and Superiorly Located Stage I Non-Small-Cell Lung Cancer

Abstract

Purpose: To minimize toxicity while maintaining tumor coverage with stereotactic body radiation therapy (SBRT) for centrally or superiorly located stage I non-small-cell lung cancer (NSCLC), we investigated passive-scattering proton therapy (PSPT) and intensity-modulated proton therapy (IMPT). Methods and Materials: Fifteen patients with centrally or superiorly located (within 2 cm of critical structures) stage I NSCLC were treated clinically with three-dimensional photon SBRT (50 Gy in 4 fractions). The photon SBRT plan was compared with the PSPT and IMPT plans. The maximum tolerated dose (MTD) was defined as the dose that exceeded the dose--volume constraints in the critical structures. Results: Only 6 photon plans satisfied the >95% planning target volume (PTV) coverage and MTD constraints, compared to 12 PSPT plans (p = 0.009) and 14 IMPT plans (p = 0.001). Compared with the photon SBRT plans, the PSPT and IMPT plans significantly reduced the mean total lung dose from 5.4 Gy to 3.5 Gy (p < 0.001) and 2.8 Gy (p < 0.001) and reduced the total lung volume receiving 5 Gy, 10 Gy, and 20 Gy (p < 0.001). When the PTV was within 2 cm of the critical structures, the PSPT and IMPT plans significantly reduced the mean maximalmore » dose to the aorta, brachial plexus, heart, pulmonary vessels, and spinal cord. Conclusions: For centrally or superiorly located stage I NSCLC, proton therapy, particularly IMPT, delivered ablative doses to the target volume and significantly reduced doses to the surrounding normal tissues compared with photon SBRT.« less

Authors:
 [1]; ;  [2];  [1]
  1. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)
  2. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)
Publication Date:
OSTI Identifier:
21587601
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2010.03.012; PII: S0360-3016(10)00417-7; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AORTA; HEART; LUNGS; NEOPLASMS; PHOTONS; PROTONS; RADIATION DOSES; RADIOTHERAPY; SPINAL CORD; TOXICITY; ARTERIES; BARYONS; BLOOD VESSELS; BODY; BOSONS; CARDIOVASCULAR SYSTEM; CENTRAL NERVOUS SYSTEM; DISEASES; DOSES; ELEMENTARY PARTICLES; FERMIONS; HADRONS; MASSLESS PARTICLES; MEDICINE; NERVOUS SYSTEM; NUCLEAR MEDICINE; NUCLEONS; ORGANS; RADIOLOGY; RESPIRATORY SYSTEM; THERAPY

Citation Formats

Register, Steven P., Zhang Xiaodong, Mohan, Radhe, and Chang, Joe Y., E-mail: jychang@mdanderson.org. Proton Stereotactic Body Radiation Therapy for Clinically Challenging Cases of Centrally and Superiorly Located Stage I Non-Small-Cell Lung Cancer. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.03.012.
Register, Steven P., Zhang Xiaodong, Mohan, Radhe, & Chang, Joe Y., E-mail: jychang@mdanderson.org. Proton Stereotactic Body Radiation Therapy for Clinically Challenging Cases of Centrally and Superiorly Located Stage I Non-Small-Cell Lung Cancer. United States. doi:10.1016/j.ijrobp.2010.03.012.
Register, Steven P., Zhang Xiaodong, Mohan, Radhe, and Chang, Joe Y., E-mail: jychang@mdanderson.org. Fri . "Proton Stereotactic Body Radiation Therapy for Clinically Challenging Cases of Centrally and Superiorly Located Stage I Non-Small-Cell Lung Cancer". United States. doi:10.1016/j.ijrobp.2010.03.012.
@article{osti_21587601,
title = {Proton Stereotactic Body Radiation Therapy for Clinically Challenging Cases of Centrally and Superiorly Located Stage I Non-Small-Cell Lung Cancer},
author = {Register, Steven P. and Zhang Xiaodong and Mohan, Radhe and Chang, Joe Y., E-mail: jychang@mdanderson.org},
abstractNote = {Purpose: To minimize toxicity while maintaining tumor coverage with stereotactic body radiation therapy (SBRT) for centrally or superiorly located stage I non-small-cell lung cancer (NSCLC), we investigated passive-scattering proton therapy (PSPT) and intensity-modulated proton therapy (IMPT). Methods and Materials: Fifteen patients with centrally or superiorly located (within 2 cm of critical structures) stage I NSCLC were treated clinically with three-dimensional photon SBRT (50 Gy in 4 fractions). The photon SBRT plan was compared with the PSPT and IMPT plans. The maximum tolerated dose (MTD) was defined as the dose that exceeded the dose--volume constraints in the critical structures. Results: Only 6 photon plans satisfied the >95% planning target volume (PTV) coverage and MTD constraints, compared to 12 PSPT plans (p = 0.009) and 14 IMPT plans (p = 0.001). Compared with the photon SBRT plans, the PSPT and IMPT plans significantly reduced the mean total lung dose from 5.4 Gy to 3.5 Gy (p < 0.001) and 2.8 Gy (p < 0.001) and reduced the total lung volume receiving 5 Gy, 10 Gy, and 20 Gy (p < 0.001). When the PTV was within 2 cm of the critical structures, the PSPT and IMPT plans significantly reduced the mean maximal dose to the aorta, brachial plexus, heart, pulmonary vessels, and spinal cord. Conclusions: For centrally or superiorly located stage I NSCLC, proton therapy, particularly IMPT, delivered ablative doses to the target volume and significantly reduced doses to the surrounding normal tissues compared with photon SBRT.},
doi = {10.1016/j.ijrobp.2010.03.012},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 80,
place = {United States},
year = {2011},
month = {7}
}