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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Four-dimensional treatment planning in layer-stacking boost irradiation for carbon-ion pancreatic therapy
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Four-dimensional treatment planning in layer-stacking boost irradiation for carbon-ion pancreatic therapy

机译：碳离子胰腺治疗的多层堆叠增强辐射中的四维治疗计划

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Purpose We evaluated respiratory-gated carbon-ion beam dose distribution with boost irradiation in pancreatic therapy and compared results between the passive scattering and layer-stacking (a kind of semi-active scanning) irradiation techniques. Materials and methods A total of 21 patients who were treated with conventional passive carbon-ion beam for pancreatic cancer underwent 4DCT imaging under free-breathing conditions. We defined two types of clinical target volume (CTV) for the initial and boost irradiations: CTV1 included the gross tumor volume (GTV) and peripheral organs, and CTV2 included the GTV only with an added uniform 2-mm margin. Planning target volumes 1 and 2 (PTV1 and PTV2) were calculated by adding the range variation considered internal margin defined by 4DCT to the respective CTVs. The initial prescribed dose (=45.6 Gy (RBE); RBE-weighted absorbed dose) was given to PTV1, and the boost dose was increased up to 26.4 Gy (RBE) and given to PTV2. Dose assessments were compared between irradiation techniques using the paired t-test. Results D95 (GTV, CTV2) values were increased from 44.2 Gy (RBE) with the prescribed dose of 45.6 Gy (RBE) to 69.8 Gy (RBE) with the prescribed dose of 72.0 Gy (RBE) with both irradiations. Layer-stacking irradiation reduced excessive dosing to normal tissues compared with passive scattering irradiation, particularly for boost irradiation. 1st-2nd portion V20/V40, and stomach V20 values up to the prescribed dose of 48.0, 60.0, and 52.8 Gy (RBE) were smaller than those in passive scattering irradiation without boost. Kidney V15/V30 (0.6% (P = 0.05)/0.1% (P > 0.20) for right kidney, 10.4% (P < 0.01)/3.2% (P < 0.01) for left kidney), pancreas V20/V40 (88.6% (P < 0.01)/83.0% (P < 0.03)), duodenum 3rd-4th portion V20/V40 (23.6% (P < 0.01)/9.5% (P > 0.06)), and stomach V20 (16.3% (P < 0.01)) values in layer-stacking irradiation were smaller than those in passive scattering irradiation up to the prescribed dose of 72.0 Gy (RBE) and also smaller than those with passive scattering irradiation without boost irradiation (=45.6 Gy (RBE)). Conclusion In pancreatic particle beam therapy, delivery of the prescribed dose by layer-stacking boost irradiation provides a greater reduction in excessive dose to normal tissues than delivery by passive scattering irradiation.
机译：目的我们评估了在胰腺治疗中采用加强照射的呼吸门控碳离子束剂量分布，并比较了被动散射和层堆叠（一种半主动扫描）照射技术的结果。材料和方法共有21例接受常规被动碳离子束治疗的胰腺癌患者在自由呼吸条件下进行了4DCT成像。我们为初始和增强照射定义了两种类型的临床目标体积（CTV）：CTV1包括总肿瘤体积（GTV）和周围器官，而CTV2仅包括GTV，并增加了2mm的均匀余量。通过将考虑了由4DCT定义的内部余量的范围变化添加到各个CTV，可以计算出计划目标体积1和2（PTV1和PTV2）。将初始处方剂量（= 45.6 Gy（RBE）; RBE加权吸收剂量）给予PTV1，加强剂量增加至26.4 Gy（RBE）并给予PTV2。使用配对t检验比较照射技术之间的剂量评估。结果在两次照射下，D95（GTV，CTV2）值均从指定剂量45.6 Gy（RBE）的44.2 Gy（RBE）增加到指定剂量72.0 Gy（RBE）的69.8 Gy（RBE）。与被动散射辐照相比，层堆叠辐照减少了对正常组织的过量剂量，特别是增强辐照。达到规定剂量48.0、60.0和52.8 Gy（RBE）的第1至第2部分V20 / V40和胃V20值均小于无加强剂量的被动散射照射时的值。肾脏V15 / V30（右肾为0.6％（P = 0.05）/0.1%（P> 0.20），左肾为10.4％（P <0.01）/3.2%（P <0.01）），胰腺V20 / V40（88.6 ％（P <0.01）/83.0%（P <0.03）），十二指肠第三至第四部分V20 / V40（23.6％（P <0.01）/9.5%（P> 0.06））和胃V20（16.3％（P ≤0.01））的值在达到72.0 Gy（RBE）的规定剂量之前比在被动散射辐照下的值要小，并且也比没有加强辐射（= 45.6 Gy（RBE））的被动散射辐照的值要小。结论在胰腺粒子束治疗中，通过层堆叠增强辐射递送规定剂量比通过被动散射辐射递送对正常组织的过量剂量的减少更大。

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