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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Intensity modulated photon and proton therapy for the treatment of head and neck tumors.
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Intensity modulated photon and proton therapy for the treatment of head and neck tumors.

机译：调强光子和质子治疗头颈部肿瘤。

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PURPOSE: A comparative treatment planning study has been performed between intensity modulated photon and proton therapy to investigate the ability of both modalities to spare organs at risk in the head and neck region while keeping target dose homogeneous. Additional advantage of reducing the spot size for IMPT was also investigated. The treatment planning comparison was extended by varying the number of fields to study its effect on the performance of each modality. Risks of secondary cancer induction were also calculated for all modalities. MATERIALS AND METHODS: Five planning CTs were selected for the study. Four different constraints were set to the organs at risk in order to measure the resulting dose homogeneity in the target volume. Five and nine field plans were made for IMXT and 3, 5 and 9 field plans were made for IMPT, for both spot sizes. Dose homogeneity as a function of the mean parotid dose was visualized using a 'pseudo' Pareto-optimal front approach. Risks of secondary cancer were estimated using the organ equivalent dose model. RESULTS: Critical organs were best spared using 3-field IMPT and, at least for IMPT, little advantage was seen with increasing field numbers. Reducing the spot size does give an advantage. In contrast, there was a significant advantage in going from 5 to 9 fields for IMXT. Secondary cancer risk was lowest for the IMPT plans with reduced spot size, for which normal tissue received the lowest integral dose. Interestingly, although integral dose remained the same, increasing the number of IMPT fields increased the secondary cancer risk, due to the increased volume of tissue irradiated to low dose. CONCLUSIONS: IMPT has a better ability to spare organs at risk than IMXT for the same dose homogeneity. It also significantly reduced the estimated risk of secondary cancer induction and the use of small numbers of fields further increased this advantage. Given that target homogeneity and normal tissue sparing were equally good with the 3 field IMPT, there appears to be a clear rationale to deliver small numbers of fields for IMPT.
机译：目的：已经在强度调制光子和质子治疗之间进行了比较治疗计划研究，以研究两种方法在保持目标剂量均匀的同时，使头颈部区域内处于危险中的器官免受伤害的能力。还研究了减少IMPT斑点尺寸的其他优势。通过改变领域的数量来扩展治疗计划的比较，以研究其对每种治疗方式的效果。还计算了所有方式的继发性癌症诱发风险。材料与方法：选择五项计划性CT进行研究。为测量处于危险中的器官设置了四个不同的限制条件，以便测量目标体积中所产生的剂量均一性。对于两种光斑大小，分别为IMXT制定了五个和九个现场计划，为IMPT制定了三个，五个和九个现场计划。剂量均一性是腮腺平均剂量的函数，使用“伪”帕累托最优前沿方法观察。使用器官当量剂量模型估算了继发癌症的风险。结果：关键器官最好使用三场IMPT来避免，至少对于IMPT，随着场数的增加几乎看不到任何优势。减小光斑尺寸确实具有优势。相反，对于IMXT，将字段从5个扩展到9个具有显着的优势。对于IMPT计划来说，继发性癌症风险最低，斑点尺寸减小，而正常组织的整体剂量最低。有趣的是，尽管积分剂量保持不变，但由于受低剂量照射的组织体积增加，增加IMPT区域的数量会增加继发癌症的风险。结论：对于相同剂量的同质性，IMPT比IMXT具有更好的风险器官免除能力。它还大大降低了估计的继发癌症的风险，使用少量田野进一步增加了这一优势。鉴于3场IMPT的目标同质性和正常组织备用性同样好，因此为IMPT提供少量场似乎是一个明确的理由。

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