Dosimetric comparison of five different techniques for craniospinal irradiation across 15 European centers: analysis on behalf of the SIOP-E-BTG (radiotherapy working group)

被引：66

作者：

Seravalli, Enrica ^{[1
,2
]}

Bosman, Mirjam ^{[1
,2
]}

Lassen-Ramshad, Yasmin ^{[3
,4
]}

Vestergaard, Anne ^{[3
,4
]}

Oldenburger, Foppe ^{[5
]}

Visser, Jorrit ^{[5
]}

Koutsouveli, Efi ^{[6
]}

Paraskevopoulou, Chryssa ^{[6
]}

Horan, Gail ^{[7
]}

Ajithkumar, Thankamma ^{[7
]}

Timmermann, Beate ^{[8
]}

Fuentes, Carolina-Sofia ^{[8
]}

Whitfield, Gillian ^{[9
,10
]}

Marchant, Thomas ^{[11
]}

Padovani, Laetitia ^{[12
]}

Gamier, Eloise ^{[12
]}

Gandola, Lorenza ^{[13
]}

Meroni, Silvia ^{[13
]}

Hoeben, Bianca A. W. ^{[14
]}

Kusters, Martijn ^{[14
]}

Alapetite, Claire ^{[15
,16
,17
,18
]}

Losa, Sandra ^{[15
,16
,17
,18
]}

Goudjil, Farid ^{[15
,16
,17
,18
]}

Magelssen, Henriette ^{[19
]}

Evensen, Morten Egeberg ^{[19
]}

Saran, Frank ^{[20
]}

Smyth, Gregory ^{[21
,22
]}

Rombi, Barbara ^{[23
]}

Righetto, Roberto ^{[23
]}

Kortmann, Rolf-Dieter ^{[24
]}

Janssens, Geert O. ^{[1
,2
]}

机构：

[1] Univ Med Ctr Utrecht, Dept Radiat Oncol, Postbox 3508, Utrecht, GA, Netherlands

[2] Princess Maxima Ctr Pediat Oncol, Postbox 3508, Utrecht, GA, Netherlands

[3] Aarhus Univ Hosp, Dept Oncol, Aarhus, Denmark

[4] Aarhus Univ Hosp, Danish Ctr Particle Therapy, Aarhus, Denmark

[5] Acad Med Ctr, Dept Radiat Oncol, Amsterdam, Netherlands

[6] Hygeia Hosp, Dept Radiat Oncol, Athens, Greece

[7] Cambridge Univ Hosp NHS Fdn Trust, Dept Oncol, Cambridge, England

[8] Univ Hosp Essen, West German Protontherapy Ctr Essen, Clin Particle Therapy, Essen, Germany

[9] Univ Manchester, Christie NHS Fdn Trust, Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England

[10] Univ Manchester, Royal Mancheste Childrens Hosp, Childrens Brain Tumour Res Network, Manchester, Lancs, England

[11] Christie NHS Fdn Trust, Manchester, Lancs, England

[12] CHU Timone, Dept Radiotherapy, Marseille, France

[13] Fdn IRCCS Ist Nazl Tumori, Pediat Radiotherapy Unit, Milan, Italy

[14] Radboud Univ Nijmegen, Dept Radiat Oncol, Med Ctr, Nijmegen, Netherlands

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

[16] Ctr Protontherapie, Paris, France

[17] Inst Curie, Dept Radiat Oncol, Orsay, France

[18] Ctr Protontherapie, Orsay, France

[19] Oslo Univ Hosp, Norwegian Radium Hosp, Dept Oncol, Oslo, Norway

[20] Royal Marsden NHS Fdn Trust, Sutton, Surrey, England

[21] Inst Canc Res, Joint Dept Phys, London, England

[22] Royal Marsden NHS Fdn Trust, London, England

[23] APSS, Protontherapy Ctr, Trento, Italy

[24] Univ Hosp Leipzig, Dept Radiat Therapy, Leipzig, Germany

来源：

ACTA ONCOLOGICA | 2018年 / 57卷 / 09期

关键词：

STANDARD-RISK MEDULLOBLASTOMA; MODULATED ARC THERAPY; CHILDRENS CANCER GROUP; RADIATION-THERAPY; ADJUVANT CHEMOTHERAPY; PEDIATRIC MEDULLOBLASTOMA; HELICAL TOMOTHERAPY; SPINAL IRRADIATION; MULTICENTER TRIAL; PROTON;

D O I：

10.1080/0284186X.2018.1465588

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Conventional techniques (3D-CRT) for craniospinal irradiation (CSI) are still widely used. Modern techniques (IMRT, VMAT, TomoTherapy (R), proton pencil beam scanning [PBS]) are applied in a limited number of centers. For a 14-year-old patient, we aimed to compare dose distributions of five CSI techniques applied across Europe and generated according to the participating institute protocols, therefore representing daily practice. Material and methods: A multicenter (n=15) dosimetric analysis of five different techniques for CSI (3D-CRT, IMRT, VMAT, TomoTherapy (R), PBS; 3 centers per technique) was performed using the same patient data, set of delineations and dose prescription (36.0/1.8 Gy). Different treatment plans were optimized based on the same planning target volume margin. All participating institutes returned their best treatment plan applicable in clinic. Results: The modern radiotherapy techniques investigated resulted in superior conformity/homogeneity-indices (CI/HI), particularly in the spinal part of the target (CI: 3D-CRT:0.3 vs. modern:0.6; HI: 3D-CRT:0.2 vs. modern:0.1), and demonstrated a decreased dose to the thyroid, heart, esophagus and pancreas. Dose reductions of >10.0 Gy were observed with PBS compared to modern photon techniques for parotid glands, thyroid and pancreas. Following this technique, a wide range in dosimetry among centers using the same technique was observed (e.g., thyroid mean dose: VMAT: 5.6-24.6 Gy; PBS: 0.3-10.1 Gy). Conclusions: The investigated modern radiotherapy techniques demonstrate superior dosimetric results compared to 3D-CRT. The lowest mean dose for organs at risk is obtained with proton therapy. However, for a large number of organs ranges in mean doses were wide and overlapping between techniques making it difficult to recommend one radiotherapy technique over another.

引用

页码：1240 / 1249

页数：10