Dosimetric comparison of proton radiation therapy, volumetric modulated arc therapy, and three-dimensional conformal radiotherapy based on intracranial tumor location

(1) Background: Selecting patients that will benefit the most from proton radiotherapy (PRT) is of major importance. This study sought to assess dose reductions to numerous organs-at-risk (OARs) with PRT, as compared to three-dimensional conformal radiotherapy (3DCRT) and volumetric-modulated arc th...

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Main Authors: Adeberg, Sebastian (Author) , Harrabi, Semi B. (Author) , Bougatf, Nina (Author) , Windisch, Paul (Author) , Bernhardt, Denise (Author) , Combs, Stephanie (Author) , Herfarth, Klaus (Author) , Debus, Jürgen (Author) , Rieken, Stefan (Author)
Format: Article (Journal)
Language:English
Published: 26 October 2018
In: Cancers
Year: 2018, Volume: 10, Issue: 11
ISSN:2072-6694
DOI:10.3390/cancers10110401
Online Access:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.3390/cancers10110401
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2072-6694/10/11/401
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Author Notes:Sebastian Adeberg, Semi B. Harrabi, Nina Bougatf, Vivek Verma, Paul Windisch, Denise Bernhardt, Stephanie E. Combs, Klaus Herfarth, Juergen Debus and Stefan Rieken
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Summary:(1) Background: Selecting patients that will benefit the most from proton radiotherapy (PRT) is of major importance. This study sought to assess dose reductions to numerous organs-at-risk (OARs) with PRT, as compared to three-dimensional conformal radiotherapy (3DCRT) and volumetric-modulated arc therapy (VMAT), as a function of tumor location. (2) Materials/Methods: Patients with intracranial neoplasms (all treated with PRT) were stratified into five location-based groups (frontal, suprasellar, temporal, parietal, posterior cranial fossa; n = 10 per group). Each patient was re-planned for 3DCRT and intensity-modulated radiotherapy (IMRT) using similar methodology, including the originally planned target and organ-at-risk (OAR) dose constraints. (3) Results: In parietal tumors, PRT showed the most pronounced dose reductions. PRT lowered doses to nearly every OAR, most notably the optical system and several contralateral structures (subventricular zone, thalamus, hippocampus). For frontal lobe cases, the greatest relative dose reductions in mean dose (Dmean) with PRT were to the infratentorial normal brain, contralateral hippocampus, brainstem, pituitary gland and contralateral optic nerve. For suprasellar lesions, PRT afforded the greatest relative Dmean reductions to the infratentorial brain, supratentorial brain, and the whole brain. Similar results could be observed in temporal and posterior cranial fossa disease. (4) Conclusions: The effectiveness and degree of PRT dose-sparing to various OARs depends on intracranial tumor location. These data will help to refine selection of patients receiving PRT, cost-effectiveness, and future clinical toxicity assessment.
Item Description:Gesehen am 22.11.2018
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers10110401