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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Irradiation with protons for the individualized treatment of patients with locally advanced rectal cancer: A planning study with clinical implications
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Irradiation with protons for the individualized treatment of patients with locally advanced rectal cancer: A planning study with clinical implications

机译：质子辐照用于局部晚期直肠癌患者的个体化治疗：一项具有临床意义的计划研究

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Background and purpose: Ongoing clinical trials aim to improve local control and overall survival rates by intensification of therapy regimen for patients with locally advanced rectal cancer. It is well known that whenever treatment is intensified, risk of therapy-related toxicity rises. An irradiation with protons could possibly present an approach to solve this dilemma by lowering the exposure to the organs-at-risk (OAR) without compromising tumor response. Material and methods: Twenty five consecutive patients were treated from 04/2009 to 5/2010. For all patients, four different treatment plans including protons, RapidArc, IMRT and 3D-conformal-technique were retrospectively calculated and analyzed according to dosimetric aspects. Results: Detailed DVH-analyses revealed that protons clearly reduced the dose to the OAR and entire normal tissue when compared to other techniques. Furthermore, the conformity index was significantly better and target volumes were covered consistent with the ICRU guidelines. Conclusions: Planning results suggest that treatment with protons can improve the therapeutic tolerance for the irradiation of rectal cancer, particularly for patients scheduled for an irradiation with an intensified chemotherapy regimen and identified to be at high risk for acute therapy-related toxicity. However, clinical experiences and long-term observation are needed to assess tumor response and related toxicity rates.
机译：背景与目的：正在进行的临床试验旨在通过加强针对局部晚期直肠癌患者的治疗方案来改善局部控制和总体生存率。众所周知，每当加强治疗时，与治疗有关的毒性的风险就会增加。质子辐照可能通过降低暴露于高危器官（OAR）的风险而不会损害肿瘤反应，从而提出解决这一难题的方法。材料和方法：从04/2009至5/2010，连续治疗了25位患者。对于所有患者，根据剂量学方面，回顾性地计算和分析了四个不同的治疗计划，包括质子，RapidArc，IMRT和3D保形技术。结果：详细的DVH分析表明，与其他技术相比，质子明显减少了OAR和整个正常组织的剂量。此外，符合性指标明显更好，并且符合ICRU指南的目标数量也包括在内。结论：计划结果表明，质子治疗可以提高对直肠癌照射的治疗耐受性，特别是对于计划采用强化化疗方案进行照射并被确定具有急性治疗相关毒性高风险的患者。但是，需要临床经验和长期观察来评估肿瘤反应和相关的毒性发生率。

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