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Dosimetric Comparison of Plans for Photon- or Proton-Beam Based Radiosurgery of Liver Metastases
Stockholm University, Faculty of Science, Department of Physics. Universidade Eduardo Mondlane, Mozambique.ORCID iD: 0000-0002-9904-7217
Stockholm University, Faculty of Science, Department of Physics.
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2016 (English)In: International Journal of Particle Therapy, ISSN 2331-5180, Vol. 3, no 2, 277-284 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: Radiosurgery treatment of liver metastases with photon beams has been an established method for more than a decade. One method commonly used is the stereotactic body radiation therapy (SBRT) technique. The aim of this study was to investigate the potential sparing of the organs at risk (OARs) that the use of intensity-modulated proton therapy (IMPT), instead of SBRT, could enable.

Patients and Methods: A comparative treatment-planning study of photon-beam and proton-beam based liver-cancer radiosurgery was performed. Ten patients diagnosed with liver metastasis and previously treated with SBRT at the Karolinska University Hospital were included in the study. New IMPT plans were prepared for all patients, while the original plans were set as reference plans. The IMPT planning was performed with the objective of achieving the same target dose coverage as with the SBRT plans. Pairwise dosimetric comparisons of the treatment plans were then performed for the OARs. A 2-sided Wilcoxon signed-rank test with significance level of 5% was carried out.

Results: Improved sparing of the OARs was made possible with the IMPT plans. There was a significant decrease of the mean doses delivered to the following risk organs: the nontargeted part of the liver (P = .002), the esophagus (P = .002), the right kidney (P = .008), the spinal cord (P = .004), and the lungs (P = .002). The volume of the liver receiving less than 15 Gy was significantly increased with the IMPT plans (P = .004).

Conclusion: The IMPT-based radiosurgery plans provided similar target coverage and significant dose reductions for the OARs compared with the photon-beam based SBRT plans. Further studies including detailed information about varying tissue heterogeneities in the beam path, due to organ motion, are required to evaluate more accurately whether IMPT is preferable for the radiosurgical treatment of liver metastases.

Place, publisher, year, edition, pages
2016. Vol. 3, no 2, 277-284 p.
Keyword [en]
liver metastases, treatment planning, stereotactic body radiation therapy, intensity-modulated proton therapy
National Category
Physical Sciences Cancer and Oncology Surgery
Research subject
Medical Radiation Physics
Identifiers
URN: urn:nbn:se:su:diva-139738DOI: 10.14338/IJPT-16-00010.1OAI: oai:DiVA.org:su-139738DiVA: diva2:1073573
Funder
Sida - Swedish International Development Cooperation Agency
Available from: 2017-02-11 Created: 2017-02-11 Last updated: 2017-07-01Bibliographically approved

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Mondlane, GracindaHenry, ThomasUreba, AnaSiegbahn, Albert
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