Acute Toxicities and Short-Term Follow-up of 64 Patients Treated with Intensity-Modulated Proton Beam Radiotherapy (IMPT) or Intensity-Modulated Photon Radiotherapy (IMRT) for Esophageal Carcinoma (EC): A Single-Center Experience

Bhangoo, R.S.; DeWees, T.A.; Julià, David; Liu, C.; Golafshar, Michael A.; Rule, William G.; Paripati, Harshita; Vora, Sujay A.; Ross, Helen J.; Ahn, Daniel H.; Beamer, Staci E.; Jaroszewski, Dawn E.; Liu, W.; Ashman, Jonathan B.; Sio, Terence T.

doi:10.1016/j.ijrobp.2019.06.2077

Cited by 1 publication

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is important to note that all plans in Group S‐I still met our institutional dose‐volume constraints for spinal cord. Clinically, we observed no spinal cord toxicity as a result of this approach to date 65 . Additionally, even though the slight worse hot spot control in target volume from Group S‐I was observed, we believe this had little influence for the plan for two reasons.…”

Section: Discussionmentioning

confidence: 73%

“…As the first group to do so, in this paper, we evaluated the impacts of two different beam angle configurations in the IMPT treatment Clinically, we observed no spinal cord toxicity as a result of this approach to date. 65 Additionally, even though the slight worse hot spot control in target volume from Group S-I was observed, we believe this had little influence for the plan for two reasons. First, the difference was quite small, <2%, and evidently under clinically acceptable level.…”

Section: Discussionmentioning

confidence: 84%

“…To help mitigate this effect, best efforts were given to match the CTV sizes and respiratory motion amplitude, so that the two groups became comparable both anatomically and also clinically, on the consensus that all patients had distal esophageal cancers requiring IMPT treatments. Second, our clinical experience as a new proton center is still relatively small 65 ; we await more cancer patients' proton experience in the future so we could help validate this experience with a larger patient cohort. Third, proton beam distal effects on OARs were not considered in this study.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Beam angle comparison for distal esophageal carcinoma patients treated with intensity‐modulated proton therapy

Feng

Sio

Rule

et al. 2020

J Applied Clin Med Phys

View full text Add to dashboard Cite

Purpose: To compare the dosimetric performances of intensity-modulated proton therapy (IMPT) plans generated with two different beam angle configurations (the Right-Left oblique posterior beams and the Superior-Inferior oblique posterior beams) for the treatment of distal esophageal carcinoma in the presence of uncertainties and interplay effect. Methods and Materials: Twenty patients' IMPT plans were retrospectively selected, with 10 patients treated with the R-L oblique posterior beams (Group R-L) and the other 10 patients treated with the S-I oblique posterior beams (Group S-I). Patients in both groups were matched by their clinical target volumes (CTVs-high and low dose levels) and respiratory motion amplitudes. Dose-volume-histogram (DVH) indices were used to assess plan quality. DVH bandwidth was calculated to evaluate plan robustness. Interplay effect was quantified using four-dimensional (4D) dynamic dose calculation with random respiratory starting phase of each fraction. Normal tissue complication probability (NTCP) for heart, liver, and lung was calculated, respectively, to estimate the clinical outcomes. Wilcoxon signed-rank test was used for statistical comparison between the two groups. Results: Compared with plans in Group R-L, plans in Group S-I resulted in significantly lower liver D mean and lung V 30Gy[RBE] with slightly higher but clinically acceptable spinal cord D max. Similar plan robustness was observed between the two groups. When interplay effect was considered, plans in Group S-I performed statistically better for heart D mean and V 30Gy[RBE] , lung Dmean and V 5Gy[RBE] , and liver D mean , with slightly increased but clinically acceptable spinal cord D max. NTCP for liver was significantly better in Group S-I. Conclusions: IMPT plans in Group S-I have better sparing of liver, heart, and lungs at the slight cost of spinal cord maximum dose protection, and are more interplayeffect resilient compared to IMPT plans in Group R-L. Our study supports the routine use of the S-I oblique posterior beams for the treatments of distal esophageal carcinoma.

show abstract

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation