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DOI 10.1016/j.phro.2026.100996

Медицинская библиотека · Physics and imaging in radiation oncology · 2026

Improved organs-of-interest dose reduction potential with intensity modulated proton therapy and breath-hold in mediastinal lymphoma.

Ta Bastiaan D P, Canters Richard A M, van der Klugt Kim, Vilches-Freixas Gloria, Kneepkens Esther, Vereijken Fleur, Cobben Maud, van den Bosch Maud, Lubken Indra, Stultiens Cissy, Velders Marije, Verstappen Tina, Tholen Gyanne, Niezink Anne G H, De Ruysscher Dirk K M, Berbée Maaike

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Аннотация

BACKGROUND AND PURPOSE: For mediastinal lymphoma patients, comparative data on intensity modulated proton therapy in breath-hold (IMPT-BH) versus other radiation techniques remain limited, particularly regarding dose-volume histogram (DVH) metrics and normal tissue complication probability (NTCP) for late side effects.

MATERIALS AND

METHODS

This retrospective in silico planning study included 58 lymphoma patients, treated between 2019 and May 2024, having 4D-CT and BH-CT available. Four plans per patient were made: volumetric arc therapy in free-breathing (VMAT-FB), VMAT-BH, IMPT-FB, and IMPT-BH. An absolute dose difference ≥ 1 Gy was considered clinically relevant, and patients were assigned to the optimal technique.

RESULTS

IMPT-BH resulted in the lowest average mean heart dose (MHD) at 5.4 Gy (p < 0.01) compared to VMAT-FB (8.0 Gy), VMAT-BH (6.3 Gy) and IMPT-FB (5.8 Gy). IMPT-BH resulted in the lowest average mean lung dose (MLD) at 6.7 Gy (p<0.01), compared to VMAT-FB (9.2 Gy), VMAT-BH (7.5 Gy), and IMPT-FB (7.3 Gy). Average bilateral mean breast dose (MBD) was lower with IMPT (2.1 Gy) compared to VMAT (3.2 Gy; p<0.01). IMPT was optimal for ≥ 69% of patients.

CONCLUSIONS

IMPT-BH achieved the lowest MHD, MLD, and bilateral MBD compared to IMPT-FB, VMAT-BH, and VMAT-FB in the majority of patients.

Для цитирования: Ta Bastiaan D P, Canters Richard A M, van der Klugt Kim, Vilches-Freixas Gloria, Kneepkens Esther, Vereijken Fleur, Cobben Maud, van den Bosch Maud, Lubken Indra, Stultiens Cissy, Velders Marije, Verstappen Tina, Tholen Gyanne, Niezink Anne G H, De Ruysscher Dirk K M, Berbée Maaike. Improved organs-of-interest dose reduction potential with intensity modulated proton therapy and breath-hold in mediastinal lymphoma.. Physics and imaging in radiation oncology. 2026. DOI: 10.1016/j.phro.2026.100996.
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