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Potential benefits of adaptive intensity-modulated proton therapy in nasopharyngeal carcinomas

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Title: Potential benefits of adaptive intensity-modulated proton therapy in nasopharyngeal carcinomas
Authors: Minatogawa, Hideki Browse this author
Yasuda, Koichi Browse this author →KAKEN DB
Dekura, Yasuhiro Browse this author
Takao, Seishin Browse this author →KAKEN DB
Matsuura, Taeko Browse this author →KAKEN DB
Yoshimura, Takaaki Browse this author →KAKEN DB
Suzuki, Ryusuke Browse this author →KAKEN DB
Yokota, Isao Browse this author →KAKEN DB
Fujima, Noriyuki Browse this author →KAKEN DB
Onimaru, Rikiya Browse this author →KAKEN DB
Shimizu, Shinichi Browse this author →KAKEN DB
Aoyama, Hidefumi Browse this author →KAKEN DB
Shirato, Hiroki Browse this author →KAKEN DB
Keywords: adaptive radiotherapy
dosimetric comparative study
intensity‐modulated radiotherapy
nasopharyngeal carcinoma
proton beam therapy
Issue Date: Jan-2021
Publisher: John Wiley & Sons
Journal Title: Journal of applied clinical medical physics
Volume: 22
Issue: 1
Start Page: 174
End Page: 183
Publisher DOI: 10.1002/acm2.13128
Abstract: Purpose To investigate potential advantages of adaptive intensity-modulated proton beam therapy (A-IMPT) by comparing it to adaptive intensity-modulated X-ray therapy (A-IMXT) for nasopharyngeal carcinomas (NPC). Methods Ten patients with NPC treated with A-IMXT (step and shoot approach) and concomitant chemotherapy between 2014 and 2016 were selected. In the actual treatment, 46 Gy in 23 fractions (46Gy/23Fx.) was prescribed using the initial plan and 24Gy/12Fx was prescribed using an adapted plan thereafter. New treatment planning of A-IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A-IMXT with A-IMPT. Results The means of the D-mean of the right parotid gland (P < 0.001), right TM joint (P < 0.001), left TM joint (P < 0.001), oral cavity (P < 0.001), supraglottic larynx (P = 0.001), glottic larynx (P < 0.001), , middle PCM (P = 0.0371), interior PCM (P < 0.001), cricopharyngeal muscle (P = 0.03643), and thyroid gland (P = 0.00216), in A-IMPT are lower than those of A-IMXT, with statistical significance. The means of, D-0.03cc, and D-mean of each sub portion of auditory apparatus and D-30% for Eustachian tube and D-0.5cc for mastoid volume in A-IMPT are significantly lower than those of A-IMXT. The mean doses to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20 Gy (RBE = 1.1). Conclusions An adaptive approach is suggested to enhance the potential benefit of IMPT compared to IMXT to reduce adverse effects for patients with NPC.
Type: article
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)

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