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Title: Craniospinal Irradiation Techniques: A Dosimetric Comparison of Proton Beams With Standard and Advanced Photon Radiotherapy

Purpose: To evaluate the dosimetric benefits of advanced radiotherapy techniques for craniospinal irradiation in cancer in children. Methods and Materials: Craniospinal irradiation (CSI) using three-dimensional conformal radiotherapy (3D-CRT), tomotherapy (TOMO), and proton beam treatment (PBT) in the scattering mode was planned for each of 10 patients at our institution. Dosimetric benefits and organ-specific radiation-induced cancer risks were based on comparisons of dose-volume histograms (DVHs) and on the application of organ equivalent doses (OEDs), respectively. Results: When we analyzed the organ-at-risk volumes that received 30%, 60%, and 90% of the prescribed dose (PD), we found that PBT was superior to TOMO and 3D-CRT. On average, the doses delivered by PBT to the esophagus, stomach, liver, lung, pancreas, and kidney were 19.4 Gy, 0.6 Gy, 0.3 Gy, 2.5 Gy, 0.2 Gy, and 2.2 Gy for the PD of 36 Gy, respectively, which were significantly lower than the doses delivered by TOMO (22.9 Gy, 4.5 Gy, 6.1 Gy, 4.0 Gy, 13.3 Gy, and 4.9 Gy, respectively) and 3D-CRT (34.6 Gy, 3.6 Gy, 8.0 Gy, 4.6 Gy, 22.9 Gy, and 4.3 Gy, respectively). Although the average doses delivered by PBT to the chest and abdomen were significantly lower than those of 3D-CRT or TOMO,more » these differences were reduced in the head-and-neck region. OED calculations showed that the risk of secondary cancers in organs such as the stomach, lungs, thyroid, and pancreas was much higher when 3D-CRT or TOMO was used than when PBT was used. Conclusions: Compared with photon techniques, PBT showed improvements in most dosimetric parameters for CSI patients, with lower OEDs to organs at risk.« less
Authors:
 [1] ;  [1] ;  [2] ; ; ; ; ;  [1] ; ;  [3] ;  [4]
  1. Proton Therapy Center, National Cancer Center, Goyang (Korea, Republic of)
  2. Department of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of)
  3. Pediatric Oncology Clinic, Center for Specific Organs Cancer, National Cancer Center, Goyang (Korea, Republic of)
  4. Neuro-Oncology Clinic, Center for Specific Organs Cancer, National Cancer Center, Goyang (Korea, Republic of)
Publication Date:
OSTI Identifier:
21590415
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 81; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2010.06.039; PII: S0360-3016(10)00890-4; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABDOMEN; CHEST; CHILDREN; COMPARATIVE EVALUATIONS; COMPUTERIZED TOMOGRAPHY; CT-GUIDED RADIOTHERAPY; ESOPHAGUS; HEAD; IRRADIATION; KIDNEYS; LIVER; LUNGS; NECK; NEOPLASMS; PANCREAS; PHOTON BEAMS; RADIATION DOSES; STOMACH; THYROID AGE GROUPS; ANIMALS; BEAMS; BODY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; DOSES; ENDOCRINE GLANDS; EVALUATION; GASTROINTESTINAL TRACT; GLANDS; MAMMALS; MAN; MEDICINE; NUCLEAR MEDICINE; ORGANS; PRIMATES; RADIOLOGY; RADIOTHERAPY; RESPIRATORY SYSTEM; THERAPY; TOMOGRAPHY; VERTEBRATES