青少年霍奇金淋巴瘤患者的质子线性能量转移和可变相对生物学有效性。

BJR open Pub Date : 2023-01-01 DOI:10.1259/bjro.20230012
Laura Ann Rechner, Maja V Maraldo, Edward Ak Smith, Anni Y Lundgaard, Lisa L Hjalgrim, Ranald I MacKay, Adam H Aitkenhead, Marianne C Aznar
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引用次数: 0

摘要

目的:由于布拉格峰,质子治疗具有理论上的剂量学优势,但线性能量转移(LET),因此相对生物有效性(RBE)在范围的末端增加。对于霍奇金淋巴瘤患者,束远端边缘通常位于心脏内或靠近心脏,RBE升高可能是潜在的问题。本研究的目的是探讨RBE和光束排列选择对青少年纵隔霍奇金淋巴瘤患者的影响。方法:对于三名先前接受过治疗的青少年患者,以11份(Varian Eclipse v13.7)的处方剂量(19.8 Gy (RBE))创建1-3场质子计划,假设RBE为1.1。使用蒙特卡罗(Geant4 v10.3.3/Gate v8.1)重新计算方案,计算剂量平均LET。可变rbe加权剂量使用麦克纳马拉模型计算,假设危险器官的α/β比为2 Gy。结果:虽然LET随着场数的增加而降低,但rbe加权剂量(Δdose)对危险器官的差异并未持续减小。Δdose值因患者和器官而异,大多在0-3 Gy (RBE)量级,最坏情况下,一个方案左心房接近最大剂量时为4.75 Gy (RBE)。结论:RBE对危险器官的加权剂量对RBE模型的选择很敏感,特别是对心脏。知识进展:在评估霍奇金淋巴瘤的质子治疗方案时,需要保持谨慎,特别是考虑到对高危器官的接近最大剂量时。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Proton linear energy transfer and variable relative biological effectiveness for adolescent patients with Hodgkin lymphoma.

Proton linear energy transfer and variable relative biological effectiveness for adolescent patients with Hodgkin lymphoma.

Proton linear energy transfer and variable relative biological effectiveness for adolescent patients with Hodgkin lymphoma.

Proton linear energy transfer and variable relative biological effectiveness for adolescent patients with Hodgkin lymphoma.

Objectives: Proton therapy has a theoretical dosimetric advantage due to the Bragg peak, but the linear energy transfer (LET), and therefore the relative biological effectiveness (RBE), increase at the end of range. For patients with Hodgkin lymphoma, the distal edge of beam is often located within or close to the heart, where elevated RBE would be of potential concern. The purpose of this study was to investigate the impact of RBE and the choice of beam arrangement for adolescent patients with mediastinal Hodgkin lymphoma.

Methods: For three previously treated adolescent patients, proton plans with 1-3 fields were created to a prescribed dose of 19.8 Gy (RBE) in 11 fractions (Varian Eclipse v13.7), assuming an RBE of 1.1. Plans were recalculated using Monte-Carlo (Geant4 v10.3.3/Gate v8.1) to calculate dose-averaged LET. Variable RBE-weighted dose was calculated using the McNamara model, assuming an α/β ratio of 2 Gy for organs-at-risk.

Results: Although the LET decreased as the number of fields increased, the difference in RBE-weighted dose (Δdose) to organs-at-risk did not consistently decrease. Δdose values varied by patient and organ and were mostly of the order of 0-3 Gy (RBE), with a worst-case of 4.75 Gy (RBE) in near-maximum dose to the left atrium for one plan.

Conclusions: RBE-weighted doses to organs-at-risk are sensitive to the choice of RBE model, which is of particular concern for the heart.

Advances in knowledge: There is a need to remain cautious when evaluating proton plans for Hodgkin lymphoma, especially when near-maximum doses to organs-at-risk are considered.

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