Dosimetric superiority of deep inspiration breath hold-proton beam therapy for cardiac metastasis.

IF 1.1 4区医学 Q4 ONCOLOGY

Medical Dosimetry Pub Date : 2025-03-28 DOI:10.1016/j.meddos.2025.02.005

Dong-Jie Chen, Man Zhao, Jia-Wei Lu, Han Sun, Wei Jiang, Jun Liang

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引用次数: 0

Abstract

The purpose of this case report is to compare the dosimetric disparities between photon radiotherapy and intensity-modulated proton therapy (IMPT) with or without deep inspiration breath hold (DIBH) for cardiac tumors. We present a case involving a 66-year-old female with cardiac metastasis from thymic carcinoma. A total dose of 50Gy/50Gy_(RBE) in 25 fractions was administered to the cardiac metastases. Two simulation CT scans were obtained during free breath (FB) and DIBH. Dose distribution to target and organs at risk(OARs) was compared between intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and IMPT. All of the 6 plans satisfied treatment planning goals. The coronary artery (CA) Dmean (mean dose) was 28.32 Gy for IMRT-DIBH, 42.66 Gy for IMRT-FB, 26.44 Gy for VMAT-DIBH, 40.85 Gy for VMAT-FB, 27.71 Gy for IMPT-DIBH, and 39.51 Gy for IMPT-FB. The heart V50 (volume receiving ≥50 Gy) was 3.90 Gy for IMRT-DIBH, 6.71 Gy for IMRT-FB, 4.80 Gy for VMAT-DIBH, 6.63 Gy for VMAT-FB, 0.99 Gy for IMPT-DIBH, and 6.67 Gy for IMPT-FB, respectively. DIBH resulted in dose reductions in all OARs, particularly the heart and CA, compared to FB in all 3 planning techniques (IMRT, VMAT, and IMPT). Similarly, compared with IMRT or VMAT, IMPT reduced radiation doses to most OARs, including the heart and CA, in both FB and DIBH. DIBH-IMPT demonstrated superior dose coverage and OARs sparing in this thymic carcinoma patient with cardiac metastasis. Given the anticipated reduction in toxicities, IMPT with DIBH is preferred for cardiac tumors. The potential for broader application of IMPT with DIBH in clinical practice is currently being evaluated, and further studies are needed.

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深吸气屏气-质子束治疗心脏转移的剂量学优势。

本病例报告的目的是比较光子放疗和强度调制质子治疗（IMPT）在有或没有深度吸气屏气（DIBH）治疗心脏肿瘤的剂量学差异。我们报告一个66岁女性胸腺癌心脏转移的病例。对心脏转移灶给予总剂量50Gy/50Gy(RBE)，共25份。在自由呼吸（FB）和DIBH期间进行两次模拟CT扫描。比较调强放疗（IMRT）、体积调弧治疗（VMAT）和调强放疗（IMPT）对靶器官和危险器官（OARs）的剂量分布。6个方案均满足治疗计划目标。冠状动脉（CA） Dmean（平均剂量）IMRT-DIBH为28.32 Gy， IMRT-FB为42.66 Gy， VMAT-DIBH为26.44 Gy， VMAT-FB为40.85 Gy， IMPT-DIBH为27.71 Gy， IMPT-FB为39.51 Gy。心脏V50（容积接收≥50 Gy） IMRT-DIBH为3.90 Gy， IMRT-FB为6.71 Gy， VMAT-DIBH为4.80 Gy， VMAT-FB为6.63 Gy， IMPT-DIBH为0.99 Gy， IMPT-FB为6.67 Gy。与FB相比，在所有3种计划技术（IMRT、VMAT和IMPT）中，DIBH导致所有OARs的剂量减少，特别是心脏和CA。同样，与IMRT或VMAT相比，IMPT在FB和DIBH中减少了对大多数OARs的辐射剂量，包括心脏和CA。DIBH-IMPT在胸腺癌合并心脏转移患者中显示出优越的剂量覆盖和OARs保留。考虑到预期的毒性降低，IMPT联合DIBH治疗心脏肿瘤是首选。目前正在评估IMPT与DIBH在临床实践中更广泛应用的潜力，需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Dosimetry 医学-核医学

CiteScore

2.40

自引率

0.00%

发文量

审稿时长

34 days

期刊介绍： Medical Dosimetry, the official journal of the American Association of Medical Dosimetrists, is the key source of information on new developments for the medical dosimetrist. Practical and comprehensive in coverage, the journal features original contributions and review articles by medical dosimetrists, oncologists, physicists, and radiation therapy technologists on clinical applications and techniques of external beam, interstitial, intracavitary and intraluminal irradiation in cancer management. Articles dealing primarily with physics will be reviewed by a specially appointed team of experts in the field.