Re-irradiation of recurrent head and neck carcinomas: comparison of robust intensity modulated proton therapy treatment plans with helical tomotherapy

Radiation Oncology

Jonathan Farr²  Sabine Levegrün³  Christoph Pöttgen³  Jehad Abu-Jawad³  Andreas Kaiser¹  Martin Stuschke¹ 

[1] Westdeutsches Protonentherapiezentrum Essen, 45147 Essen, Germany;Current address: Department of Radiologic Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA;Department of Radiotherapy, University Duisburg-Essen, 45147 Essen, Germany

关键词: Helical tomotherapy;    Re-irradiation;    Plan comparison;    Robustness;    Robust optimization;    Intensity modulated proton therapy;    IMPT;   

Others  :  1154152
DOI  :  10.1186/1748-717X-8-93

 received in 2013-03-18, accepted in 2013-04-09,  发布年份 2013

【 摘 要 】

Background

To test the hypothesis that the therapeutic ratio of intensity-modulated photon therapy using helical tomotherapy (HT) for retreatment of head and neck carcinomas can be improved by robust intensity-modulated proton therapy (IMPT).

Methods

Comparative dose planning with robust IMPT was performed for 7 patients retreated with HT.

Results

On average, HT yielded dose gradients steeper in a distance ≤ 7.5 mm outside the target (p<0.0001, F-test) and more conformal high dose regions down to the 50% isodose than IMPT. Both methods proved comparably robust against set-up errors of up to 2 mm, and normal tissue exposure was satisfactory. The mean body dose was smaller with IMPT.

Conclusions

IMPT was found not to be uniformly superior to HT and the steeper average dose fall-off around the target volume is an argument pro HT under the methodological implementations used. However, looking at single organs at risk, the normal tissue sparing of IMPT can surpass tomotherapy for an individual patient. Therefore, comparative dose planning is recommended, if both methods are available.

【 授权许可】

   
2013 Stuschke et al.; licensee BioMed Central Ltd.

【 图 表 】

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