Dose distribution resulting from changes in aeration of nasal cavity or paranasal sinus cancer in the proton therapy

Fukumitsu, Nobuyoshi; Ishikawa, Hitoshi; Ohnishi, Kayoko; Terunuma, Toshiyuki; Mizumoto, Masashi; Numajiri, Haruko; Aihara, Teruhito; Okumura, Toshiyuki; Tsuboi, Koji; Sakae, Takeji; Sakurai, Hideyuki

doi:10.1016/j.radonc.2014.08.024

Cited by 33 publications

(32 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar findings were recently published for the cohort of 20 patients treated with proton therapy for nasal cavity or paranasal sinus cavities . The air content in the cavities increased in 18 out 20 cases.…”

Section: Discussionsupporting

confidence: 88%

“…We focused on dosimetric changes that might justify a need for adaptive proton planning. As it is well known, the proton ranges are very susceptible to changes in air cavities within radiation fields . Nevertheless, our study has shown that in most of the cases the coverage of target volumes was not compromised substantially even for the patients that were rescanned late in the course of treatment and for those who exhibited a pronounced change in aeration within the cavity.…”

Section: Discussionmentioning

confidence: 53%

See 1 more Smart Citation

Impact of aeration change and beam arrangement on the robustness of proton plans

Shusharina

Fullerton

Adams

et al. 2019

J Applied Clin Med Phys

View full text Add to dashboard Cite

This study determines the impact of change in aeration in sinonasal cavities on the robustness of passive‐scattering proton therapy plans in patients with sinonasal and nasopharyngeal malignancies. Fourteen patients, each with one planning CT and one CT acquired during radiotherapy were studied. Repeat and planning CTs were rigidly aligned and contours were transferred using deformable registration. The amount of air, tumor, and fluid within the cavity containing the tumor were measured on both CTs. The original plans were recalculated on the repeat CT. Dosimetric changes were measured for the targets and critical structures. Median decrease in gross tumor volume (GTV) was 19.8% and correlated with the time of rescan. The median change in air content was 7.1% and correlated with the tumor shrinkage. The median of the mean dose Dmean change was +0.4% for GTV and +0.3% for clinical target volume. Median change in the maximum dose Dmax of the critical structures were as follows: optic chiasm +0.66%, left optic nerve +0.12%, right optic nerve +0.38%, brainstem +0.6%. The dose to the GTV decreased by more than 5% in 1 case, and the dose to critical structure(s) increased by more than 5% in three cases. These four patients had sinonasal cancers and were treated with anterior proton fields that directly transversed through the involved sinus cavities. The change in dose in the replanning was strongly correlated with the change in aeration (P = 0.02). We found that the change in aeration in the vicinity of the target and the arrangement of proton beams affected the robustness of proton plan.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 53%

Impact of aeration change and beam arrangement on the robustness of proton plans

Shusharina

Fullerton

Adams

et al. 2019

J Applied Clin Med Phys

View full text Add to dashboard Cite

show abstract

“…A potential pitfall of this technique in sinonasal cancer treatment is the complex interaction between setup errors and anatomical uncertainties (ie, variations in nasal cavity and paranasal sinuses filling) that could occur during treatment with potential relevant differences between the nominal dose distribution (calculated on the planning CT) and the actual delivered dose [17]. In light of this, weekly verification CT scans with the implementation of 3-dimensional image-guided protocols in proton therapy [18] are recommended to establish the need for replanning.…”

Section: Discussionmentioning

confidence: 99%

Unresectable Ameloblastoma Successfully Treated with Definitive Proton Therapy

Dionisi

Amichetti

Algranati

et al. 2017

International Journal of Particle Therapy

View full text Add to dashboard Cite

We report the case of an 87-year-old man affected by an unresectable ameloblastoma of the right jaw that was successfully treated by definitive proton therapy up to a dose of 66 Gy in 33 fractions. Treatment was well tolerated, and there were no interruptions due to toxicity. At follow-up visits, the patient experienced complete response to treatment with no evidence of disease and complete recovery from acute side effects. In this report, we discuss the potential and possible pitfalls of proton therapy in the treatment of specific settings.

show abstract

“…However, further improvement in the local control of this disease using IMRT seems di cult due to contradiction between its need for high required radical dose to the tumor and the dose limits of the surrounding normal tissues. As a result, the dominance of IMRT is being challenged by a new charged particle radiotherapy mode, termed as proton beam therapy (PBT), which possesses superior dose distribution afforded by protons' "Bragg peaks" [5,6]. According to an authoritative systematical review, compared to IMRT, PBT has been found to improve the 5-year overall survival rate of paranasal sinus and nasal cavity cancer from 45.1% to 69.7% [7].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of proton beam therapy for treatment decision making in paranasal sinus and nasal cavity cancers in China

Guo

Qiu

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Cost-effectiveness is a pivotal consideration for clinical decision making of high-tech cancer treatment in developing countries. Intensity-modulated proton radiation therapy (IMPT, the advanced form of proton beam therapy) has been found to improve the prognosis of the patients with paranasal sinus and nasal cavity cancers compared with intensity-modulated photon-radiation therapy (IMRT). However, the cost-effectiveness of IMPT has not yet been fully evaluated. This study aimed at evaluating the cost-effectiveness of IMPT versus IMRT for treatment decision making of paranasal sinus and nasal cavity cancers in Chinese settings.Methods: A 3-state Markov model was designed for cost-effectiveness analysis. A base case evaluation was performed on a patient of 47-year-old (median age of patients with paranasal sinus and nasal cavity cancers in China). Model robustness was examined by probabilistic sensitivity analysis, Markov cohort analysis and Tornado diagram. Cost-effective scenarios of IMPT were further identified by one-way sensitivity analyses and stratified analyses were performed for different age levels. The outcome measure of the model was the incremental cost-effectiveness ratio (ICER). A strategy was defined as cost-effective if the ICER was below the societal willingness-to-pay (WTP) threshold of China (30,828 US dollars ($) / quality-adjusted life year (QALY)).Results: IMPT was identified as being cost-effective for the base case at the WTP of China, providing an extra 1.65 QALYs at an additional cost of $38,928.7 compared with IMRT, and had an ICER of $23,611.2 / QALY. Of note, cost-effective scenarios of IMPT only existed in the following independent conditions: probability of IMPT eradicating cancer ≥ 0.867; probability of IMRT eradicating cancer ≤ 0.764; or cost of IMPT ≤ $52,163.9. Stratified analyses for different age levels demonstrated that IMPT was more cost-effective in younger patients than older patients, and was cost-effective only in patients ≤ 56-year-old.Conclusions: Despite initially regarded as bearing high treatment cost, IMPT could still be cost-effective for patients with paranasal sinus and nasal cavity cancers in China. The tumor control superiority of IMPT over IMRT and the patient’s age should be the principal considerations for clinical decision of prescribing this new irradiation technique.

show abstract

Dose distribution resulting from changes in aeration of nasal cavity or paranasal sinus cancer in the proton therapy

Abstract: Background and Purpose: Aeration in the nasal cavity and paranasal

Cited by 33 publications

References 21 publications

Impact of aeration change and beam arrangement on the robustness of proton plans

Impact of aeration change and beam arrangement on the robustness of proton plans

Unresectable Ameloblastoma Successfully Treated with Definitive Proton Therapy

Cost-effectiveness analysis of proton beam therapy for treatment decision making in paranasal sinus and nasal cavity cancers in China

Contact Info

Product

Resources

About