Abstract
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 (IMPTMLC+ or IMPTMLC-, 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 D2%, V90%, V95%, homogeneity index (HI), and conformity index (CI). Organs at risk (OARs) were evaluated
using the average dose (Dmean) and D2%. Furthermore, the dose to the normal brain was evaluated using from V5Gy to V40Gy at 5 Gy intervals. There were no significant differences among all techniques regarding
V90%, V95%, and CI for the targets. HI and D2% for IMPTMLC+ and IMPTMLC- were significantly superior to those for VMAT (p < 0.01). The Dmean and D2% of all OARs for IMPTMLC+ were equivalent or superior to those of other techniques. Regarding the normal brain,
there was no significant difference in V40Gy among all techniques whereas V5Gy to V35Gy in IMPTMLC+ were significantly smaller than those in IMPTMLC- (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). IMPTMLC+ could reduce the dose to OARs, while maintaining target coverage compared to IMPTMLC- and VMAT in treating malignant glioma.
Keywords
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References
- The epidemiology of glioma in adults: A state of the science review.Neuro. Oncol. 2014; 16: 896-913
- Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma.N. Engl. J. Med. 2005; 352: 987-996
- Radiation therapy for glioblastoma: American Society of Clinical Oncology Clinical Practice guideline endorsement of the American Society for Radiation Oncology guideline.J. Clin. Oncol. 2017; 35: 361-369
- Treatment planning for volumetric modulated arc therapy.Med. Phys. 2009; 36: 5128-5138
- Simultaneous integrated boost volumetric modulated arc therapy for middle or lower esophageal cancer using elective nodal irradiation: Comparison with 3D conformal radiotherapy.Acta. Med. Okayama. 2019; 73: 247-254
- Pediatric craniospinal irradiation with a short partial-arc VMAT technique for medulloblastoma tumors in dosimetric comparison.Radiat. Oncol. 2020; 15: 1-10
- A dosimetric and radiobiological evaluation of VMAT following mastectomy for patients with left-sided breast cancer.Radiat. Oncol. 2021; 16: 1-11
- Volumetric modulated arc therapy versus intensity-modulated proton therapy in neoadjuvant irradiation of locally advanced oesophageal cancer.Radiat. Oncol. 2020; 15: 120
- Intensity modulated proton therapy (IMPT) – The future of IMRT for head and neck cancer.Oral Oncol. 2019; 88: 66-74
- Treatment planning comparison of IMPT, VMAT and 4Π radiotherapy for prostate cases.Radiat. Oncol. 2017; 12: 1-9
- Development and evaluation of a short-range applicator for treating superficial moving tumors with respiratory-gated spot-scanning proton therapy using real-time image guidance.Phys. Med. Biol. 2016; 61: 1515-1531
- A patient-specific aperture system with an energy absorber for spot scanning proton beams: Verification for clinical application.Med. Phys. 2015; 42: 6999-7010
- A study of lateral fall-off (penumbra) optimisation for pencil beam scanning (PBS) proton therapy.Phys. Med. Biol. 2018; 63025022
- Evaluation of dosimetric advantages of using patient-specific aperture system with intensity-modulated proton therapy for the shallow depth tumor.J. Appl. Clin. Med. Phys. 2018; 19: 132-137
- Technical note: A treatment plan comparison between dynamic collimation and a fixed aperture during spot scanning proton therapy for brain treatment.Med. Phys. 2016; 43: 4693-4699
- Intensity-modulated proton therapy, volumetric-modulated arc therapy, and 3D conformal radiotherapy in anaplastic astrocytoma and glioblastoma.Strahlenther. Onkol. 2016; 192: 770-779
- Intensity-modulated proton therapy decreases dose to organs at risk in low-grade glioma patients: results of a multicentric in silico ROCOCO trial.Acta Oncol. 2019; 58: 57-65
- Dose distribution of intensity-modulated proton therapy with and without a multi-leaf collimator for the treatment of maxillary sinus cancer: A comparative effectiveness study.Radiat. Oncol. 2019; 14: 209
- Dose distribution effects of spot-scanning proton beam therapy equipped with a multi-leaf collimator for pediatric brain tumors.Oncol. Lett. 2021; 22: 1-8
- ESTRO-ACROP guideline “target delineation of glioblastomas.Radiother. Oncol. 2016; 118: 35-42
- The EPTN consensus-based atlas for CT- and MR-based contouring in neuro-oncology.Radiother. Oncol. 2018; 128: 37-43
- Organs at risk in the brain and their dose-constraints in adults and in children: A radiation oncologist's guide for delineation in everyday practice.Radiother. Oncol. 2015; 114: 230-238
- Use of normal tissue complication probability (NTCP) models in the clinic.Int. J. Radiat. Oncol. Biol. Phys. 2010; 76: S10-S19
- A simple scoring ratio to index the conformity of radiosurgical treatment plans. Technical note.J. Neurosurg. 2000; 93: 219-222
- Investigation of the freely available easy-to-use software “EZR” for medical statistics.Bone Marrow Transplant. 2013; 48: 452-458
- Dosimetric comparison of proton radiation therapy, volumetric modulated arc therapy, and three-dimensional conformal radiotherapy based on intracranial tumor location.Cancers (Basel). 2018; 10: 401
- Dosimetric analysis of radiation-induced brainstem necrosis for nasopharyngeal carcinoma treated with IMRT.BMC Cancer. 2022; 22: 1-8
- Lens dose-response prediction modeling and cataract incidence in patients with retinoblastoma after lens-sparing or whole-eye radiation therapy.Int. J. Radiat. Oncol. 2019; 103: 1143-1150
- Prospective study of inner ear radiation dose and hearing loss in head-and-neck cancer patients.Int. J. Radiat. Oncol. Biol. Phys. 2005; 61: 1393-1402
- The posterior cerebellum, a new organ at risk?.Clin. Transl. Radiat. Oncol. 2018; 8: 22-26
- Cognitive functioning after radiotherapy or chemoradiotherapy for head-and-neck cancer.Int. J. Radiat. Oncol. Biol. Phys. 2011; 81: 126-134
- Tolerance of normal tissue to therapeutic irradiation.Int. J. Radiat. Oncol. Biol. Phys. 1991; 21: 109-122
- MRI of radiation injury to the brain.Am. J. Roentgenol. 1986; 147: 119-124
- Impact of spot size and beam-shaping devices on the treatment plan quality for pencil beam scanning proton therapy.Int. J. Radiat. Oncol. Biol. Phys. 2016; 95: 190-198
Article info
Publication history
Published online: March 11, 2023
Accepted:
January 26,
2023
Received in revised form:
January 24,
2023
Received:
July 21,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
