Optimizing radiotherapy of orbital and paraorbital tumors: intensity-modulated X-ray beams vs. intensity-modulated proton beams(109 visite) Miralbell R, Cella L, Weber D, Lomax A
Parole chiave: Intensity Modulation, Meningioma, Orbital Tumors, Protontherapy, Rhabdomyosarcoma, Article, Beam Therapy, Case Report, Human, Lymphoma, Optic Nerve Tumor, Orbit Tumor, Priority Journal, Radiation Dose Distribution, Radiation Injury, Treatment Planning, X Ray, Optic Nerve Neoplasms, Orbital Neoplasms, Radiotherapy, Conformal, Skull Neoplasms, Sphenoid Bone, Tomography, X-Ray Computed,
Affiliazioni:
Division de Radio-Oncologie, Hôpitaux Universitaires, Genève, Switzerland Strahlenmedizin Abteilung, Paul Scherrer Institut, Villigen, Switzerland
Riferimenti:
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Wygoda, M. R., Eisbruch, A., Lichter, A. S., Primary orbital and ocular adnexal lymphomas: Excellent outcome with radiotherapy (1999) Proc ASCO, 18, p. 32. , (Abstr.)
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Lee, A. G., Woo, S. Y., Miller, N. R., Improvement in visual function in an eye with presumed optic nerve sheath meningioma after treatment with three-dimensional conformal radiation therapy (1996) J Clin Neuro Ophthalmol, 16, pp. 247-251
Kupersmith, M. J., Warren, F. A., Newall, J., Irradiation of meningiomas of the intracranial anterior visual pathway (1987) Ann Neurol, 21, pp. 131-137
Goldsmith, B. J., Wara, W. M., Wilson, C. B., Postoperative irradiation for subtotally resected meningiomas (1994) J Neurosurg, 80, pp. 195-201
Crist, W. M., Garnsey, L., Beltangady, M. S., Prognosis in children with Rhabdomyosarcoma: A report of the Intergroup Rhabdomyosarcoma Studies I and II (1990) J Clin Oncol, 8, pp. 443-452
Archambeau, J. O., Slater, J. D., Slater, J. M., Role for proton beam irradiation in treatment of pediatric CNS malignancies (1992) Int J Radiat Oncol Biol Phys, 22, pp. 287-294
Slater, J. M., Slater, J. D., Archambeau, J. O., Carcinoma of the tonsillar region: Potential for use of proton beam therapy (1992) Int J Radiat Oncol Biol Phys, 22, pp. 311-319
Lomax, A. J., Bortfeld, T., Goitein, G., A treatment planning inter-comparison of proton and intensity modulated photon radiotherapy (1999) Radiother Oncol, 51, pp. 257-271
Lyman, J. T., Complication probability as assessed from dose-volume histograms (1985) Radiat Res, 104, pp. 513-519
Eng, T. Y., Albright, N. W., Kuwahara, G., Precision radiation therapy for optic nerve sheath meningiomas (1992) Int J Radiat Oncol Biol Phys, 22, pp. 1093-1098
Regine, W. F., Fontanesi, J., Kumar, P., Local tumor control in rhabdomyosarcoma following low-dose irradiation: Comparison of group II and selected group III patients (1995) Int J Radiat Oncol Biol Phys, 31, pp. 485-491
Raney, R. B., Wharam, M., Glicksman, A. S., Late sequelae in survivors of localized non-orbital rhabdomyosarcoma of the head and neck: A final report from IRSG studies II and III, 1978-1987 (1998) Med Pediatr Oncol, 31, p. 233. , (Abstr.)
Parsons, J. T., Bova, F. J., Fitzgerald, C. R., Severe dry-eye syndrome following external beam irradiation (1994) Int J Radiat Oncol Biol Phys, 30, pp. 775-780
Purpose: This study presents a dosimetric optimization effort aiming to compare intensity-modulated (IM) X-rays and IM protons in 4 different orbital and paraorbital tumors. These are most challenging targets for standard radiotherapy due to their close relationship with the eyes and related structures.Methods and Materials: A primary orbital lymphoma, an optic nerve meningioma, a sphenoidal ridge meningioma protruding into the orbit, and a pediatric parameningeal paraorbital rhabdomyosarcoma were selected for the purpose of this study. Planning target volumes (PTVs) and organs at risk (OAR) were defined in each patient CT data set for each tumor site. IM X-ray and IM proton three-dimensional treatment plans were implemented. The following total tumor doses were prescribed: 30 Gy for the orbital lymphoma, 54 Gy for both meningiomas, and 50.4 Gy for the rhabdomyosarcoma case. Dose-volume histograms (DVHs) were obtained for all targets and OAR with both treatment techniques. DVHs were used to predict normal tissue complication probabilities (NTCPs) for the OAR in the vicinity of the tumor.Results: The PTV coverage was optimal and equally homogeneous with both IM X-rays and IM proton plans in the 4 tumor sites. DVHs for most OAR were better with IM proton beams especially in the low- to mid-dose range region. The integral nontarget dose was lower with IM protons in every case (factor ranging from 1.5 to 1.9). However, predicted NTCPs (for severe late effects) were equally low for both treatment techniques in every tumor site.Conclusion: Although IM proton plans optimally decreased the dose to the OAR in all tumor sites, both optimized X-ray and proton beams equally succeeded to reduce severe-toxicity prediction risks to less than 5% while optimally treating the PTV. Copyright (C) 2000 Elsevier Science Inc.
127 Records (116 escludendo Abstract e Conferenze). Impact factor totale: 313.363 (282.003 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 361.144 (324.807 escludendo Abstract e Conferenze).
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