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  • Flejmer, Anna M.Linköping University,Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Onkologiska kliniken US,Medicinska fakulteten,Linköping Univ, Dept Oncol, Linköping, Sweden; Linköping Univ, Dept Clin & Expt Med, Linköping, Sweden (author)

Respiratory gating for proton beam scanning versus photon 3D-CRT for breast cancer radiotherapy

  • Article/chapterEnglish2016

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  • 2016
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:liu-123274
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-123274URI
  • https://doi.org/10.3109/0284186X.2015.1120883DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-298013URI
  • https://lup.lub.lu.se/record/775ee512-4354-4ac8-8ac3-6340074b7b9aURI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • Funding agencies:  LiU Cancer research network at Linkoping University; Region Ostergotland; ALF Grants from Region Ostergotland (Sweden)
  • Background Respiratory gating and proton therapy have both been proposed to reduce the cardiopulmonary burden in breast cancer radiotherapy. This study aims to investigate the additional benefit of proton radiotherapy for breast cancer with and without respiratory gating.Material and methods Twenty left-sided patients were planned on computed tomography (CT)-datasets acquired during enhanced inspiration gating (EIG) and free-breathing (FB), using photon three-dimensional conformal radiation therapy (3D-CRT) and scanned proton beams. Ten patients received treatment to the whole breast only (WBO) and 10 were treated to the breast and the regional lymph nodes (BRN). Dosimetric parameters characterizing the coverage of target volumes and the cardiopulmonary burden were compared using a paired, two-tailed Student’s t-test.Results Protons ensured comparable or better target coverage than photons in all patients during both EIG and FB. The heterogeneity index decreased from 12% with photons to about 5% with protons. The mean dose to the ipsilateral lung was reduced in BRN patients from 12 Gy to 7 Gy (RBE) in EIG and from 14 Gy to 6-7 Gy (RBE) in FB, while for WBO patients all values were about 5-6 Gy (RBE). The mean dose to heart decreased by a factor of four in WBO patients [from 1.1 Gy to 0.3 Gy (RBE) in EIG and from 2.1 Gy to 0.5 Gy (RBE) in FB] and 10 in BRN patients [from 2.1 Gy to 0.2 Gy (RBE) in EIG and from 3.4 Gy to 0.3 Gy (RBE) in FB]. Similarly, the mean and the near maximum dose to left anterior descending artery (LAD) were significantly lower (p<0.05) with protons in comparison with photons.Conclusion Proton spot scanning has a high potential to reduce the irradiation of organs at risk and other normal tissues for most patients, beyond what could be achieved with EIG and photon therapy. The largest dose sparing has been seen for BRN patients, both in terms of cardiopulmonary burden and integral dose.

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  • Edvardsson, AnneliLund University,Lunds universitet,Medicinsk strålningsfysik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medical Radiation Physics, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University, Sweden(Swepub:lu)med-ae5 (author)
  • Dohlmar, FridaLinköping University,Linköpings universitet,Avdelningen för radiologiska vetenskaper,Medicinska fakulteten,Region Östergötland, Radiofysikavdelningen US,Linköping Univ, Dept Radiat Phys, Linköping, Sweden; Linköping Univ, Dept Med & Hlth Sci, Linköping, Sweden(Swepub:liu)frias94 (author)
  • Josefsson, DanLinköping University,Linköpings universitet,Medicinska fakulteten,Avdelningen för radiologiska vetenskaper,Region Östergötland, Radiofysikavdelningen US,Linköping Univ, Dept Radiat Phys, Linköping, Sweden; Linköping Univ, Dept Med & Hlth Sci, Linköping, Sweden(Swepub:lu)extLU-1238 (author)
  • Nilsson, MatsFuturum - Academy for Health and Care, Jönköping, Sweden,Cty Council Jönköping Futurum, Acad Hlth & Care, Jönköping, Sweden,Jönköping County Council(Swepub:lu)rfa-mni (author)
  • Witt Nyström, PetraUppsala universitet,Enheten för onkologi,Uppsala University Hospital, Sweden(Swepub:uu)petwi362 (author)
  • Dasu, AlexandruLinköping University,Linköpings universitet,Medicinska fakulteten,Avdelningen för radiologiska vetenskaper,Region Östergötland, Radiofysikavdelningen US,Linköping Univ, Dept Radiat Phys, Linköping, Sweden; Linköping Univ, Dept Med & Hlth Sci, Linköping, Sweden(Swepub:uu)aleda511 (author)
  • Linköpings universitetAvdelningen för kliniska vetenskaper (creator_code:org_t)

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  • In:Acta Oncologica55:5, s. 577-5830284-186X1651-226X

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