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NTCP modeling analysis of acute hematologic toxicity in whole pelvic radiation therapy for gynecologic malignancies : A dosimetric comparison of IMRT and spot-scanning proton therapy (SSPT)

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Title: NTCP modeling analysis of acute hematologic toxicity in whole pelvic radiation therapy for gynecologic malignancies : A dosimetric comparison of IMRT and spot-scanning proton therapy (SSPT)
Authors: Yoshimura, Takaaki Browse this author
Kinoshita, Rumiko Browse this author →KAKEN DB
Onodera, Shunsuke Browse this author
Toramatsu, Chie Browse this author
Suzuki, Ryusuke Browse this author →KAKEN DB
Ito, Yoichi M. Browse this author →KAKEN DB
Takao, Seishin Browse this author →KAKEN DB
Matsuura, Taeko Browse this author →KAKEN DB
Matsuzaki, Yuka Browse this author
Umegaki, Kikuo Browse this author
Shirato, Hiroki Browse this author →KAKEN DB
Shimizu, Shinichi Browse this author →KAKEN DB
Keywords: Whole pelvic radiation therapy
Spot-scanning proton therapy
LKB-NTCP model analysis
Treatment planning study
Issue Date: Sep-2016
Publisher: Elsevier
Journal Title: Physica medica : European journal of medical physics
Volume: 32
Issue: 9
Start Page: 1095
End Page: 1102
Publisher DOI: 10.1016/j.ejmp.2016.08.007
PMID: 27567089
Abstract: Purpose: This treatment planning study was conducted to determine whether spot scanning proton beam therapy (SSPT) reduces the risk of grade ⩾3 hematologic toxicity (HT3+) compared with intensity modulated radiation therapy (IMRT) for postoperative whole pelvic radiation therapy (WPRT). Methods and materials: The normal tissue complication probability (NTCP) of the risk of HT3+ was used as an in silico surrogate marker in this analysis. IMRT and SSPT plans were created for 13 gynecologic malignancy patients who had received hysterectomies. The IMRT plans were generated using the 7-fields step and shoot technique. The SSPT plans were generated using anterior-posterior field with single field optimization. Using the relative biological effectives (RBE) value of 1.0 for IMRT and 1.1 for SSPT, the prescribed dose was 45 Gy(RBE) in 1.8 Gy(RBE) per fractions for 95% of the planning target volume (PTV). The homogeneity index (HI) and the conformity index (CI) of the PTV were also compared. Results: The bone marrow (BM) and femoral head doses using SSPT were significantly lower than with IMRT. The NTCP modeling analysis showed that the risk of HT3+ using SSPT was significantly lower than with IMRT (NTCP = 0.04 ± 0.01 and 0.19 ± 0.03, p = 0.0002, respectively). There were no significant differences in the CI and HI of the PTV between IMRT and SSPT (CI = 0.97 ± 0.01 and 0.96 ± 0.02, p = 0.3177, and HI = 1.24 ± 0.11 and 1.27 ± 0.05, p = 0.8473, respectively). Conclusion: The SSPT achieves significant reductions in the dose to BM without compromising target coverage, compared with IMRT. The NTCP value for HT3+ in SSPT was significantly lower than in IMRT.
Rights: http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article
URI: http://hdl.handle.net/2115/64570
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 木下 留美子

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