Journal of applied clinical medical physics · 2026
Proton arc therapy reduces the dose delivered to circulating blood compared to intensity-modulated proton therapy for head-and-neck cancer.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tattenberg Sebastian, Liu Peilin, Cong Xiaoda, Hoehr Cornelia, Ding Xuanfeng
Аннотация
BACKGROUND: Compared to intensity-modulated proton therapy (IMPT), proton arc therapy (PAT) has various dosimetric advantages. However, questions have been raised over whether the larger low-dose bath during PAT may increase radiation-induced lymphocyte killing, which is correlated with adverse clinical outcomes.
PURPOSE: The purpose of this study is to quantitatively compare radiation dose delivery to circulating blood during IMPT and PAT.
METHODS: For each of 10 head-and-neck cancer patients, one IMPT and one PAT treatment plan were created, and the hematological dose (HEDOS) blood dose model was used to simulate radiation dose delivery to circulating blood. HEDOS simulations utilized gantry angle-wise dose distributions (including for PAT) and considered gantry rotation and energy layer switching as well as irradiation times. Blood dose histograms as well as the mean dose to all simulation blood particles (Dmean) and the dose delivered to the 90% and 10% of blood particles receiving the highest dose (D90% and D10%) were then compared between IMPT and PAT.
RESULTS: For IMPT, blood dose metrics (in the form of mean over all patients ± one standard deviation) were (0.522 ± 0.204)Gy(RBE) for D90%, (0.563 ± 0.212)Gy(RBE) for Dmean, and (0.605 ± 0.219)Gy(RBE) for D10%. For PAT, D90% was (0.430 ± 0.184)Gy(RBE), Dmean was (0.483 ± 0.195)Gy(RBE), and D10% was (0.538 ± 0.207)Gy(RBE). The Wilcoxon signed-rank test indicated statistically significant (p < 0.05) differences between blood dose metrics of IMPT and PAT for all patients, and IMPT did not increase the percentage of blood particles which received no radiation dose during the delivery of a single treatment fraction.
CONCLUSIONS: Compared to IMPT, proton arc therapy was associated with significantly lower radiation dose delivery to circulating blood across a variety of different metrics. Proton arc therapy for head-and-neck cancer is therefore not expected to result in higher radiation-induced killing of circulating lymphocytes compared to IMPT.
PURPOSE: The purpose of this study is to quantitatively compare radiation dose delivery to circulating blood during IMPT and PAT.
METHODS: For each of 10 head-and-neck cancer patients, one IMPT and one PAT treatment plan were created, and the hematological dose (HEDOS) blood dose model was used to simulate radiation dose delivery to circulating blood. HEDOS simulations utilized gantry angle-wise dose distributions (including for PAT) and considered gantry rotation and energy layer switching as well as irradiation times. Blood dose histograms as well as the mean dose to all simulation blood particles (Dmean) and the dose delivered to the 90% and 10% of blood particles receiving the highest dose (D90% and D10%) were then compared between IMPT and PAT.
RESULTS: For IMPT, blood dose metrics (in the form of mean over all patients ± one standard deviation) were (0.522 ± 0.204)Gy(RBE) for D90%, (0.563 ± 0.212)Gy(RBE) for Dmean, and (0.605 ± 0.219)Gy(RBE) for D10%. For PAT, D90% was (0.430 ± 0.184)Gy(RBE), Dmean was (0.483 ± 0.195)Gy(RBE), and D10% was (0.538 ± 0.207)Gy(RBE). The Wilcoxon signed-rank test indicated statistically significant (p < 0.05) differences between blood dose metrics of IMPT and PAT for all patients, and IMPT did not increase the percentage of blood particles which received no radiation dose during the delivery of a single treatment fraction.
CONCLUSIONS: Compared to IMPT, proton arc therapy was associated with significantly lower radiation dose delivery to circulating blood across a variety of different metrics. Proton arc therapy for head-and-neck cancer is therefore not expected to result in higher radiation-induced killing of circulating lymphocytes compared to IMPT.