Department of Radiation Oncology, University of California San Diego, La Jolla, CA, USA.
J Appl Clin Med Phys. 2010 Aug 15;11(4):3255. doi: 10.1120/jacmp.v11i4.3255.
The objective was to compare intensity-modulated radiation therapy (IMRT) with 3D conformal proton therapy (3DCPT) in the treatment of cervical cancer. In particular, each technique's ability to spare pelvic bone marrow (PBM) was of primary interest in this study. A total of six cervical cancer patients (3 postoperative and 3 intact) were planned and analyzed. All plans had uniform 1.0 cm CTV-PTV margin and satisfied the 95% PTV with 100% isodose (prescription dose = 45 Gy) coverage. Dose-volume histograms (DVH) were analyzed for comparison. The overall PTV and PBM volumes were 1035.9 ± 192.2 cc and 1151.4 ± 198.3 cc, respectively. In terms of PTV dose conformity index (DCI) and dose homogeneity index (DHI), 3DCPT was slightly superior to IMRT with 1.00 ± 0.001, 1.01 ± 0.02, and 1.10 ± 0.02, 1.13 ± 0.01, respectively. In addition, 3DCPT demonstrated superiority in reducing lower doses (i.e., V30 or less) to PBM, small bowel and bladder. Particularly in PBM, average V10 and V20 reductions of 10.8% and 7.4% (p = 0.001 and 0.04), respectively, were observed. However, in the higher dose range, IMRT provided better sparing (> V30). For example, in small bowel and PBM, average reductions in V45 of 4.9% and 10.0% (p = 0.048 and 0.008), respectively, were observed. Due to its physical characteristics such as low entrance dose, spread-out Bragg peak and finite particle range of protons, 3DCPT illustrated superior target coverage uniformity and sparing of the lower doses in PBM and other organs. Further studies are, however, needed to fully exploit the benefits of protons for general use in cervical cancer.
目的是比较调强放疗（IMRT）与三维适形质子治疗（3DCPT）在宫颈癌治疗中的效果。本研究主要关注两种技术保护骨盆骨髓（PBM）的能力。共计划和分析了 6 例宫颈癌患者（3 例术后和 3 例完整）。所有计划均有统一的 1.0 cm CTV-PTV 边界，满足 95% PTV 接受 100%等剂量线（处方剂量=45 Gy）覆盖。通过分析剂量体积直方图（DVH）进行比较。全 PTV 和 PBM 体积分别为 1035.9±192.2 cc 和 1151.4±198.3 cc。在 PTV 剂量适形指数（DCI）和剂量均匀性指数（DHI）方面，3DCPT 略优于 IMRT，分别为 1.00±0.001、1.01±0.02 和 1.10±0.02、1.13±0.01。此外，3DCPT 在降低 PBM、小肠和膀胱的低剂量（即 V30 及以下）方面具有优势。特别是在 PBM 中，V10 和 V20 的平均降低率分别为 10.8%和 7.4%（p=0.001 和 0.04）。然而，在较高剂量范围内，IMRT 提供了更好的保护（>V30）。例如，在小肠和 PBM 中，V45 的平均降低率分别为 4.9%和 10.0%（p=0.048 和 0.008）。由于质子的物理特性，如低入射剂量、扩展布拉格峰和有限的粒子射程，3DCPT 显示出更好的靶区覆盖均匀性和对 PBM 及其他器官的低剂量的保护。然而，仍需要进一步的研究来充分利用质子在宫颈癌中的广泛应用的优势。
Zotero 插件
