估计直肠癌光子和质子治疗后继发性癌症的风险：一项计算幻影研究

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics Pub Date : 2025-08-25 DOI:10.1016/j.ejmp.2025.105083

Nipon Saiwong , Sasikarn Chamchod , Pattarakan Suwanbut , Sawanee Suntiwong , Thiansin Liamsuwan

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引用次数: 0

摘要

目的本研究的目的是评估直肠癌调强放射治疗（IMRT）和调强质子治疗（IMPT）后继发癌症的风险。方法采用计算男性幻影法代表泰国直肠癌患者。采用Ethos治疗计划系统（TPS）计算12场6 MV无压扁滤波（FFF）光子束的IMRT计划，采用matRad计算2场（侧向和斜向）、3场和5场的IMPT计划。通过粒子模拟工具（TOPAS）蒙特卡罗模拟重新计算了IMPT计划，以考虑二次辐射。根据器官等效剂量（OED）和终生归因风险（LAR），采用机制模型评估继发性癌症风险。结果IMPT计划对危险器官（OARs）的辐射剂量低于IMRT计划。IMRT计划的器官特异性LARs为结肠2.247%，肠道0.098%，膀胱0.038%，而IMPT计划的LARs范围为结肠1.475%至1.537%，肠道0.014%至0.016%，膀胱0.071%至0.092%。结肠是患继发性癌症的风险最高的。除IMRT病例外，发生继发性骨和软组织肉瘤以及场外器官继发性癌症的风险可忽略不计。结论在所调查的IMRT和IMPT方案中，2视野斜位IMPT方案的风险最低。

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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Estimation of secondary cancer risks following rectal cancer photon and proton therapy: A computational phantom study

Purpose

The aim of this work was to assess secondary cancer risks after rectal cancer intensity modulated radiation therapy (IMRT) and intensity modulated proton therapy (IMPT) using a computational phantom.

Method

A computational male phantom was used to represent Thai rectal cancer patients. Ethos treatment planning system (TPS) was used to calculate the IMRT plan with 12 fields of 6 MV flattening filter free (FFF) photon beams, while matRad was employed to calculate IMPT plans with 2 (lateral and oblique), 3 and 5 fields. The IMPT plans were recalculated by Tool for Particle Simulation (TOPAS) Monte Carlo simulation to account for secondary radiations. The assessment of secondary cancer risks in terms of organ equivalent dose (OED) and lifetime attributable risk (LAR) was conducted using the mechanistic model.

Results

The IMPT plans yielded lower radiation doses to the organs at risk (OARs) than the IMRT plan. The organ-specific LARs for the IMRT plan were 2.247 % for the colon, 0.098 % for the bowel and 0.038 % for the bladder, while the LARs for the IMPT plans ranged from 1.475 % to 1.537 % for the colon, 0.014 % to 0.016 % for the bowel, and 0.071 % to 0.092 % for the bladder. The colon was found to have the highest risk of developing secondary cancer. The risks of developing secondary bone and soft tissue sarcomas as well as secondary cancer in out-of-field organs were negligibly low except in the IMRT case.

Conclusion

Among the investigated IMRT and IMPT plans, the 2-field oblique IMPT plan yielded the lowest risk.

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来源期刊

Physica Medica-European Journal of Medical Physics 生物-生物物理

CiteScore

6.80

自引率

14.70%

发文量

493

审稿时长

78 days

期刊介绍： Physica Medica, European Journal of Medical Physics, publishing with Elsevier from 2007, provides an international forum for research and reviews on the following main topics: Medical Imaging Radiation Therapy Radiation Protection Measuring Systems and Signal Processing Education and training in Medical Physics Professional issues in Medical Physics.