Proton therapy for head and neck squamous cell carcinomas: A review of the physical and clinical challenges

被引：40

作者：

Beddok, Arnaud ^{[1
]}

Vela, Anthony ^{[2
,3
]}

Calugaru, Valentin ^{[1
]}

Tessonnier, Thomas ^{[2
,3
]}

Kubes, Jiri ^{[4
]}

Dutheil, Pauline ^{[2
,3
]}

Gerard, Anais ^{[5
]}

Vidal, Marie ^{[5
]}

Goudjil, Farid ^{[1
]}

Florescu, Carmen ^{[2
,3
]}

Kammerer, Emmanuel ^{[2
,3
]}

Benezery, Karen ^{[5
]}

Herault, Joel ^{[5
]}

Poortmans, Philip ^{[1
,6
]}

Bourhis, Jean ^{[7
]}

Thariat, Juliette ^{[2
,3
,8
]}

机构：

[1] Inst Curie, Dept Radiat Oncol, Paris, France

[2] Normandie Univ, Unicaen, Ctr Francois Badesse, Dept Radiat Oncol, Caen, France

[3] ARCHADE Adv Resource Ctr Hadrontherapy Europe, Caen, France

[4] Proton Therapy Ctr Czech, Prague, Czech Republic

[5] Ctr Antoine Lacassagne, Dept Radiat Oncol, Nice, France

[6] PSL Univ, Paris Sci & Lettres, Paris, France

[7] CHU Vaudois, Dept Radiat Oncol, Lausanne, Switzerland

[8] Normandie Univ, Unicaen, Lab Phys Corpusculaire, IN2P3 ENSICAEN,UMR6534, Caen, France

来源：

RADIOTHERAPY AND ONCOLOGY | 2020年 / 147卷

关键词：

Proton therapy; Squamous Cell Carcinoma of Head and Neck; Radiation therapy planning; Computer-assisted; Radiation tolerance; INTENSITY-MODULATED PHOTON; DUAL-ENERGY CT; RADIATION-THERAPY; OROPHARYNGEAL CANCER; TREATMENT UNCERTAINTIES; RBE VARIATIONS; RADIOTHERAPY; RANGE; MODEL; SELECTION;

D O I：

10.1016/j.radonc.2020.03.006

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The quality of radiation therapy has been shown to significantly influence the outcomes for head and neck squamous cell carcinoma (HNSCC) patients. The results of dosimetric studies suggest that intensity-modulated proton therapy (IMPT) could be of added value for HNSCC by being more effective than intensity-modulated (photon) radiation therapy (IMRT) for reducing side effects of radiation ther-apy. However, the physical properties of protons make IMPT more sensitive than photons to planning uncertainties. This could potentially have a negative effect on the quality of IMPT planning and delivery. For this review, the three French proton therapy centers collaborated to evaluate the differences between IMRT and IMPT. The review explored the effects of these uncertainties and their management for devel-oping a robust and optimized IMPT treatment delivery plan to achieve clinical outcomes that are superior to those for IMRT. We also provide practical suggestions for the management of HNSCC carcinoma with IMPT. Because metallic dental implants can increase range uncertainties (3-10%), patient preparation for IMPT may require more systematic removal of in-field alien material than is done for IMRT. Multi-energy CT may be an alternative to calculate more accurately the dose distribution. The practical aspects that we describe are essential to guarantee optimal quality in radiation therapy in both model-based and ran-domized clinical trials. (c) 2020 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 147 (2020) 30-39

引用

页码：30 / 39

页数：10

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