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首页> 外文期刊>Medical dosimetry: official journal of the American Association of Medical Dosimetrists >A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT)
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A comprehensive dosimetric study of pancreatic cancer treatment using three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), volumetric-modulated radiation therapy (VMAT), and passive-scattering and modulated-scanning proton therapy (PT)

机译：使用三维共形放射疗法（3DCRT），强度调制放射疗法（IMRT），体积调制放射疗法（VMAT）以及被动散射和调制扫描质子疗法（PT）进行的胰腺癌综合剂量学研究

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With traditional photon therapy to treat large postoperative pancreatic target volume, it often leads to poor tolerance of the therapy delivered and may contribute to interrupted treatment course. This study was performed to evaluate the potential advantage of using passive-scattering (PS) and modulated-scanning (MS) proton therapy (PT) to reduce normal tissue exposure in postoperative pancreatic cancer treatment. A total of 11 patients with postoperative pancreatic cancer who had been previously treated with PS PT in University of Pennsylvania Roberts Proton Therapy Center from 2010 to 2013 were identified. The clinical target volume (CTV) includes the pancreatic tumor bed as well as the adjacent high-risk nodal areas. Internal (iCTV) was generated from 4-dimensional (4D) computed tomography (CT), taking into account target motion from breathing cycle. Three-field and 4-field 3D conformal radiation therapy (3DCRT), 5-field intensity-modulated radiation therapy, 2-arc volumetric-modulated radiation therapy, and 2-field PS and MS PT were created on the patients' average CT. All the plans delivered 50.4Gy to the planning target volume (PTV). Overall, 98% of PTV was covered by 95% of the prescription dose and 99% of iCTV received 98% prescription dose. The results show that all the proton plans offer significant lower doses to the left kidney (mean and V18Gy), stomach (mean and V20Gy), and cord (maximum dose) compared with all the photon plans, except 3-field 3DCRT in cord maximum dose. In addition, MS PT also provides lower doses to the right kidney (mean and V18Gy), liver (mean dose), total bowel (V20Gy and mean dose), and small bowel (V15Gy absolute volume ratio) compared with all the photon plans and PS PT. The dosimetric advantage of PT points to the possibility of treating tumor bed and comprehensive nodal areas while providing a more tolerable treatment course that could be used for dose escalation and combining with radiosensitizing chemotherapy.
机译：使用传统的光子疗法来治疗术后较大的胰腺目标体积，通常会导致所提供疗法的耐受性差，并可能导致治疗过程中断。这项研究的目的是评估在胰腺癌术后使用被动散射（PS）和调制扫描（MS）质子治疗（PT）减少正常组织暴露的潜在优势。确定了总共11例术后胰腺癌患者，这些患者先前于2010年至2013年在宾夕法尼亚大学罗伯茨质子治疗中心接受过PS PT治疗。临床目标体积（CTV）包括胰腺肿瘤床以及邻近的高风险淋巴结区域。内部（iCTV）由4维（4D）计算机断层扫描（CT）生成，同时考虑了来自呼吸循环的目标运动。在患者的平均CT上创建了三场和4场3D保形放射疗法（3DCRT），5场强度调制放射疗法，2弧体积调制放射疗法以及2场PS和MS PT。所有计划均交付了50.4Gy的计划目标体积（PTV）。总体而言，98％的PTV被95％的处方剂量所覆盖，而99％的iCTV被98％的处方剂量所覆盖。结果表明，与所有光子计划相比，所有质子计划对左肾（平均和V18Gy），胃（平均和V20Gy）和脐带（最大剂量）的剂量显着降低，但最大3线3DCRT除外剂量。此外，与所有光子计划相比，MS PT还为右肾（平均和V18Gy），肝脏（平均剂量），总肠（V20Gy和平均剂量）和小肠（绝对体积比V15Gy）提供较低剂量。 PS PT。 PT的剂量学优势表明可以治疗肿瘤床和广泛的结节区域，同时提供更可耐受的治疗过程，可用于剂量递增和放疗化疗。

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