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- Title
A comparative study of dose distribution of PBT, 3D-CRT and IMRT for pediatric brain tumors.
- Authors
Daichi Takizawa; Masashi Mizumoto; Tetsuya Yamamoto; Yoshiko Oshiro; Hiroko Fukushima; Takashi Fukushima; Toshiyuki Terunuma; Toshiyuki Okumura; Koji Tsuboi; Hideyuki Sakurai; Takizawa, Daichi; Mizumoto, Masashi; Yamamoto, Tetsuya; Oshiro, Yoshiko; Fukushima, Hiroko; Fukushima, Takashi; Terunuma, Toshiyuki; Okumura, Toshiyuki; Tsuboi, Koji; Sakurai, Hideyuki
- Abstract
<bold>Introduction: </bold>It was reported that proton beam therapy (PBT) reduced the normal brain dose compared with X-ray therapy for pediatric brain tumors. We considered whether there was not the condition that PBT was more disadvantageous than intensity modulated photon radiotherapy (IMRT) and 3D conventional radiotherapy (3D-CRT) for treatment of pediatric brain tumors about the dose reduction for the normal brain when the tumor location or tumor size were different.<bold>Methods: </bold>The subjects were 12 patients treated with PBT at our institute, including 6 cases of ependymoma treated by local irradiation and 6 cases of germinoma treated by irradiation of all four cerebral ventricles. IMRT and 3D-CRT treatment plans were made for these 12 cases, with optimization using the same planning conditions as those for PBT. Model cases were also compared using sphere targets with different diameters or locations in the brain, and the normal brain doses with PBT, IMRT and 3D-CRT were compared using the same planning conditions.<bold>Results: </bold>PBT significantly reduced the average dose to normal brain tissue compared to 3D-CRT and IMRT in all cases. There was no difference between 3D-CRT and IMRT. The average normal brain doses for PBT, 3D-CRT, and IMRT were 5.1-34.8% (median 14.9%), 11.0-48.5% (23.8%), and 11.5-53.1% (23.5%), respectively, in ependymoma cases; and 42.3-61.2% (48.9%), 54.5-74.0% (62.8%), and 56.3-72.1% (61.2%), respectively, in germinoma cases. In the model cases, PBT significantly reduced the average normal brain dose for larger tumors and for tumors located at the periphery of the brain.<bold>Conclusion: </bold>PBT reduces the average dose to normal brain tissue, compared with 3D-CRT and IMRT. The effect is higher for a tumor that is larger or located laterally.
- Subjects
BRAIN tumors; TUMORS in children; PROTON therapy; CANCER radiotherapy; RADIATION doses; COMPARATIVE studies; GLIOMAS; RESEARCH methodology; MEDICAL cooperation; COMPUTERS in medicine; RADIOTHERAPY; RESEARCH; EVALUATION research; GERMINOMA
- Publication
Radiation Oncology, 2017, Vol 12, p1
- ISSN
1748-717X
- Publication type
journal article
- DOI
10.1186/s13014-017-0775-2