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

Hashimoto, Takayuki; Shimizu, Shinichi; Takao, Seishin et al.

Journal of Radiation Research, 2019, 60(4), 527-537

Permalink : https://hdl.handle.net/2115/76343

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https://doi.org/10.1093/jrr/rrz022     41

論文情報

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アクセス権
open access
URI
https://hdl.handle.net/2115/76343
タイトル
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
著者
Hashimoto, Takayuki ; Shimizu, Shinichi ; Takao, Seishin ; Terasaka, Shunsuke ; Iguchi, Akihiro ; Kobayashi, Hiroyuki ; Mori, Takashi ; Yoshimura, Takaaki ; Matsuo, Yuto ; Tamura, Masaya ; Matsuura, Taeko ; Ito, Yoichi M. ; Onimaru, Rikiya ; Shirato, Hiroki
e-Rad_Researcher
60400678
著者名
Hashimoto, Takayuki
e-Rad_Researcher
50463724
著者名
Shimizu, Shinichi
e-Rad_Researcher
10614216
著者名
Takao, Seishin
e-Rad_Researcher
10447055
著者名
Terasaka, Shunsuke
著者名
Iguchi, Akihiro
e-Rad_Researcher
70374478
著者名
Kobayashi, Hiroyuki
著者名
Mori, Takashi
著者名
Yoshimura, Takaaki
著者名
Matsuo, Yuto
e-Rad_Researcher
40504775
著者名
Tamura, Masaya
e-Rad_Researcher
90590266
著者名
Matsuura, Taeko
e-Rad_Researcher
10334236
著者名
Ito, Yoichi M.
e-Rad_Researcher
80374461
著者名
Onimaru, Rikiya
e-Rad_Researcher
20187537
著者名
Shirato, Hiroki
言語
英語
キーワード
Craniospinal irradiation
Intensity-modulated spot-scanning proton therapy
Adolescents and young adults
Vertebral body sparing
Hematologic toxicity
Beam delivery time
発行日
2019-07
出版者
Oxford University Press
収録物名
Journal of Radiation Research
巻(号)
60(4)
ページ
527-537
抄録
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.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
権利情報
Creative Commons Attribution 4.0 International
PISSN
0449-3060
EISSN
1349-9157
関連情報
PMID
31111946
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1093/jrr/rrz022