RO14_1_209.pdf 1.11 MB
Sugiyama, Soichi Departments of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine
Katsui, Kuniaki Departments of Proton Beam Therapy, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine ORCID Kaken ID
Tominaga, Yuki Department of Radiation Technology, Tsuyama Chuo Hospital
Waki, Takahiro Department of Radiology, Tsuyama Chuo Hospital, Tusyama
Katayama, Norihisa Departments of Radiology, Okayama University Hospital
Matsuzaki, Hidenobu Departments of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital Kaken ID
Kariya, Shin Departments of Otolaryngology-Head and Neck Surgery, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine Kaken ID
Kuroda, Masahiro Department of Radiological Technology, Graduate School of Health Sciences, Okayama University
Nishizaki, Kazunori Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID
Kanazawa, Susumu Departments of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine Kaken ID
BACKGROUND: Severe complications, such as eye damage and dysfunciton of salivary glands, have been reported after radiotherapy among patients with head and neck cancer. Complications such as visual impairment have also been reported after proton therapy with pencil beam scanning (PBS). In the case of PBS, collimation can sharpen the penumbra towards surrounding normal tissue in the low energy region of the proton beam. In the current study, we examined how much the dose to the normal tissue was reduced by when intensity-modulated proton therapy (IMPT) was performed using a multi-leaf collimator (MLC) for patients with maxillary sinus cancer.
Computed tomography findings of 26 consecutive patients who received photon therapy at Okayama University Hospital were used in this study. We compared D2% of the region of interest (ROI; ROI-D2%) and the mean dose of ROI (ROI-mean) with and without the use of an MLC. The organs at risk (OARs) were the posterior retina, lacrimal gland, eyeball, and parotid gland. IMPT was performed for all patients. The spot size was approximately 5-6 mm at the isocenter. The collimator margin was calculated by enlarging the maximum outline of the target from the beam's eye view and setting the margin to 6 mm. All plans were optimized with the same parameters.
The mean of ROI-D2% for the ipsilateral optic nerve was significantly reduced by 0.48 Gy, and the mean of ROI-mean for the ipsilateral optic nerve was significantly reduced by 1.04 Gy. The mean of ROI-mean to the optic chiasm was significantly reduced by 0.70 Gy. The dose to most OARs and the planning at risk volumes were also reduced.
Compared with the plan involving IMPT without an MLC, in the dose plan involving IMPT using an MLC for maxillary sinus cancer, the dose to the optic nerve and optic chiasm were significantly reduced, as measured by the ROI-D2% and the ROI-mean. These findings demonstrate that the use of an MLC during IMPT for maxillary sinus cancer may be useful for preserving vision and preventing complications.
Intensity-modulated proton therapy
Maxillary sinus cancer
Pencil beam scanning
© The Author(s). 2019
|Web of Science KeyUT|
Sugiyama, S., Katsui, K., Tominaga, Y. et al. Dose distribution of intensity-modulated proton therapy with and without a multi-leaf collimator for the treatment of maxillary sinus cancer: a comparative effectiveness study. Radiat Oncol 14, 209 (2019) doi:10.1186/s13014-019-1405-y