Title: | Clinical experience of craniospinal intensity-modulated spot-scanning proton therapy using large fields for central nervous system medulloblastomas and germ cell tumors in children, adolescents, and young adults |
Authors: | Hashimoto, Takayuki Browse this author →KAKEN DB |
Shimizu, Shinichi Browse this author →KAKEN DB |
Takao, Seishin Browse this author →KAKEN DB |
Terasaka, Shunsuke Browse this author →KAKEN DB |
Iguchi, Akihiro Browse this author |
Kobayashi, Hiroyuki Browse this author →KAKEN DB |
Mori, Takashi Browse this author |
Yoshimura, Takaaki Browse this author |
Matsuo, Yuto Browse this author |
Tamura, Masaya Browse this author →KAKEN DB |
Matsuura, Taeko Browse this author →KAKEN DB |
Ito, Yoichi M. Browse this author →KAKEN DB |
Onimaru, Rikiya Browse this author →KAKEN DB |
Shirato, Hiroki Browse this author →KAKEN DB |
Keywords: | Craniospinal irradiation |
Intensity-modulated spot-scanning proton therapy |
Adolescents and young adults |
Vertebral body sparing |
Hematologic toxicity |
Beam delivery time |
Issue Date: | Jul-2019 |
Publisher: | Oxford University Press |
Journal Title: | Journal of Radiation Research |
Volume: | 60 |
Issue: | 4 |
Start Page: | 527 |
End Page: | 537 |
Publisher DOI: | 10.1093/jrr/rrz022 |
PMID: | 31111946 |
Abstract: | The outcomes of intensity-modulated proton craniospinal irradiation (ipCSI) are unclear. We evaluated the clinical benefit of our newly developed ipCSI system that incorporates two gantry-mounted orthogonal online X-ray imagers with a robotic six-degrees-of-freedom patient table. Nine patients (7-19 years old) were treated with ipCSI. The prescribed dose for CSI ranged from 23.4 to 36.0 Gy (relative biological effectiveness) in 13-20 fractions. Four adolescent and young adult (AYA) patients (15 years or older) were treated with vertebral-bodysparing ipCSI (VBSipCSI). Myelosuppression following VBSipCSI was compared with that of eight AYA patients treated with photon CSI at the same institution previously. The mean homogeneity index (HI) in the nine patients was 0.056 (95% confidence interval: 0.044-0.068). The mean time from the start to the end of all beam delivery was 37 min 39 s +/- 2 min 24 s (minimum to maximum: 22 min 49 s - 42 min 51 s). The nadir white blood cell, hemoglobin, and platelet levels during the 4 weeks following the end of the CSI were significantly higher in the VBSipCSI group than in the photon CSI group (P = 0.0071, 0.0453, 0.0024, respectively). The levels at 4 weeks after the end of CSI were significantly higher in the VBSipCSI group than in the photon CSI group (P = 0.0023, 0.0414, 0.0061). Image-guided ipCSI was deliverable in a reasonable time with sufficient HI. Using VBSipCSI, AYA patients experienced a lower incidence of serious acute hematological toxicity than AYA patients treated with photon CSI. |
Rights: | https://creativecommons.org/licenses/by/4.0/ |
Type: | article |
URI: | http://hdl.handle.net/2115/76343 |
Appears in Collections: | 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) 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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