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

Journal Article · Tue Nov 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.06.039· OSTI ID:21590415

Yoon, Myonggeun ^[1]; Shin, Dong Ho ^[1]; Kim, Jinsung ^[2]; Kim, Jong Won; Kim, Dae Woong; Park, Sung Yong; Lee, Se Byeong; Kim, Joo Young ^[1]; Park, Hyeon-Jin; Park, Byung Kiu ^[3]; Shin, Sang Hoon ^[4]

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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)

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, 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.

• OSTI ID: 21590415
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 81, 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); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

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