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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Article info
Publication history
Published online: March 11, 2023
Accepted:
January 26,
2023
Received in revised form:
January 24,
2023
Received:
July 21,
2022
Identification
Copyright
© 2023 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
