Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Okayama, Japan; Department of Radiological Technology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Okayama, Japan; Department of Radiotherapy, Medical Co. Hakuhokai, Osaka Proton Therapy Clinic, Osaka, Osaka, Japan.
Med Dosim. 2023;48(2):105-112. doi: 10.1016/j.meddos.2023.01.008. Epub 2023 Mar 12.
This study aimed to examine the dosimetric effect of intensity-modulated proton therapy (IMPT) with a multi-leaf collimator (MLC) in treating malignant glioma. We compared the dose distribution of IMPT with or without MLC (IMPT or IMPT, respectively) using pencil beam scanning and volumetric-modulated arc therapy (VMAT) in simultaneous integrated boost (SIB) plans for 16 patients with malignant gliomas. High- and low-risk target volumes were assessed using D, V, V, homogeneity index (HI), and conformity index (CI). Organs at risk (OARs) were evaluated using the average dose (D) and D. Furthermore, the dose to the normal brain was evaluated using from V to V at 5 Gy intervals. There were no significant differences among all techniques regarding V, V, and CI for the targets. HI and D for IMPT and IMPT were significantly superior to those for VMAT (p < 0.01). The D and D of all OARs for IMPT were equivalent or superior to those of other techniques. Regarding the normal brain, there was no significant difference in V among all techniques whereas V to V in IMPT were significantly smaller than those in IMPT (with differences ranging from 0.45% to 4.80%, p < 0.05) and VMAT (with differences ranging from 6.85% to 57.94%, p < 0.01). IMPT could reduce the dose to OARs, while maintaining target coverage compared to IMPT and VMAT in treating malignant glioma.
本研究旨在探讨在恶性脑胶质瘤治疗中使用多叶准直器（MLC）的强度调制质子治疗（IMPT）的剂量学效应。我们比较了 16 例恶性脑胶质瘤患者同步整合推量（SIB）计划中使用笔形束扫描和容积调强弧形治疗（VMAT）的 IMPT 与 IMPT （分别为 IMPT 或 IMPT）的剂量分布。使用 D、V、V、均匀性指数（HI）和适形性指数（CI）评估高风险和低风险靶区。使用平均剂量（D）和 D 评估危及器官（OARs）。此外，还评估了正常脑从 V 到 V 间隔 5 Gy 的剂量。在靶区方面，所有技术的 V、V 和 CI 没有显著差异。IMPT 和 IMPT 的 HI 和 D 明显优于 VMAT（p < 0.01）。IMPT 的所有 OAR 的 D 和 D 与其他技术相当或更好。关于正常脑，所有技术的 V 之间没有显著差异，而 IMPT 的 V 到 V 明显小于 IMPT（差异范围为 0.45%至 4.80%，p < 0.05）和 VMAT（差异范围为 6.85%至 57.94%，p < 0.01）。与 IMPT 和 VMAT 相比，IMPT 可以降低 OAR 剂量，同时保持对恶性脑胶质瘤的靶区覆盖。
