与三维适形放疗或调强放疗相比，质子放疗可显著降低I期或III期非小细胞肺癌患者的正常组织剂量。

Significant reduction of normal tissue dose by proton radiotherapy compared with three-dimensional conformal or intensity-modulated radiation therapy in Stage I or Stage III non-small-cell lung cancer.

作者信息

Chang Joe Y, Zhang Xiaodong, Wang Xiaochun, Kang Yixiu, Riley Beverly, Bilton Stephen, Mohan Radhe, Komaki Ritsuko, Cox James D

机构信息

Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.

出版信息

Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):1087-96. doi: 10.1016/j.ijrobp.2006.01.052. Epub 2006 May 6.

DOI:10.1016/j.ijrobp.2006.01.052

PMID:16682145

Abstract

PURPOSE

To compare dose-volume histograms (DVH) in patients with non-small-cell lung cancer (NSCLC) treated by photon or proton radiotherapy.

METHODS AND MATERIALS

Dose-volume histograms were compared between photon, including three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and proton plans at doses of 66 Gy, 87.5 Gy in Stage I (n=10) and 60-63 Gy, and 74 Gy in Stage III (n=15).

RESULTS

For Stage I, the mean total lung V5, V10, and V20 were 31.8%, 24.6%, and 15.8%, respectively, for photon 3D-CRT with 66 Gy, whereas they were 13.4%, 12.3%, and 10.9%, respectively, with proton with dose escalation to 87.5 cobalt Gray equivalents (CGE) (p=0.002). For Stage III, the mean total lung V5, V10, and V20 were 54.1%, 46.9%, and 34.8%, respectively, for photon 3D-CRT with 63 Gy, whereas they were 39.7%, 36.6%, and 31.6%, respectively, for proton with dose escalation to 74 CGE (p=0.002). In all cases, the doses to lung, spinal cord, heart, esophagus, and integral dose were lower with proton therapy even compared with IMRT.

CONCLUSIONS

Proton treatment appears to reduce dose to normal tissues significantly, even with dose escalation, compared with standard-dose photon therapy, either 3D-CRT or IMRT.

摘要

目的

比较接受光子或质子放射治疗的非小细胞肺癌（NSCLC）患者的剂量体积直方图（DVH）。

方法与材料

比较了光子放疗（包括三维适形放疗（3D-CRT）、调强放疗（IMRT））和质子计划在I期（n = 10）66 Gy、87.5 Gy剂量以及III期（n = 15）60 - 63 Gy和74 Gy剂量下的剂量体积直方图。

结果

对于I期，66 Gy的光子3D-CRT治疗中，肺平均总体积V5、V10和V20分别为31.8%、24.6%和15.8%，而质子治疗剂量递增至87.5钴灰当量（CGE）时，相应数值分别为13.4%、12.3%和10.9%（p = 0.002）。对于III期，63 Gy的光子3D-CRT治疗中，肺平均总体积V5、V10和V20分别为54.1%、46.9%和34.8%，而质子治疗剂量递增至74 CGE时，相应数值分别为39.7%、36.6%和31.6%（p = 0.002）。在所有情况下，与IMRT相比，质子治疗对肺、脊髓、心脏、食管的剂量以及积分剂量都更低。