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Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors

Background: Layer-stacking irradiation (LSI) results in the accumulation of multiple small spread-out Bragg peaks along the beam direction. Although the superiority of LSI to conventional passive irradiation (CPI) regarding normal tissue sparing is theoretically evident, the clinical benefit of LSI...

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Autores principales: Kubo, Nobuteru, Kubota, Yoshiki, Oike, Takahiro, Kawamura, Hidemasa, Sakai, Makoto, Imamura, Ayaka, Komatsu, Shuichiro, Miyasaka, Yuhei, Sato, Hiro, Musha, Atsushi, Okano, Naoko, Shirai, Katsuyuki, Saitoh, Jun-ichi, Chikamatsu, Kazuaki, Ohno, Tatsuya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456805/
https://www.ncbi.nlm.nih.gov/pubmed/32923391
http://dx.doi.org/10.3389/fonc.2020.01396
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author Kubo, Nobuteru
Kubota, Yoshiki
Oike, Takahiro
Kawamura, Hidemasa
Sakai, Makoto
Imamura, Ayaka
Komatsu, Shuichiro
Miyasaka, Yuhei
Sato, Hiro
Musha, Atsushi
Okano, Naoko
Shirai, Katsuyuki
Saitoh, Jun-ichi
Chikamatsu, Kazuaki
Ohno, Tatsuya
author_facet Kubo, Nobuteru
Kubota, Yoshiki
Oike, Takahiro
Kawamura, Hidemasa
Sakai, Makoto
Imamura, Ayaka
Komatsu, Shuichiro
Miyasaka, Yuhei
Sato, Hiro
Musha, Atsushi
Okano, Naoko
Shirai, Katsuyuki
Saitoh, Jun-ichi
Chikamatsu, Kazuaki
Ohno, Tatsuya
author_sort Kubo, Nobuteru
collection PubMed
description Background: Layer-stacking irradiation (LSI) results in the accumulation of multiple small spread-out Bragg peaks along the beam direction. Although the superiority of LSI to conventional passive irradiation (CPI) regarding normal tissue sparing is theoretically evident, the clinical benefit of LSI has not been demonstrated. Here, we compared LSI with CPI using the same treatment planning-computed tomography images used for carbon ion radiotherapy (CIRT). Methods: Twenty-one parotid tumors were analyzed. The clinical target volume (CTV) 1 and CTV2 encompassed the parotid grand and the tumor, respectively. CTV1 and CTV2 received 36 Gy (RBE: relative biological effectiveness) in nine fractions and 64 Gy (RBE) in 16 fractions, respectively, using either LSI or CPI. CTV coverage was assessed by DX%, which is the dose covering at least X% of the target volume. Skin dose was assessed by SX, which is the skin surface area receiving at least X Gy (RBE). Results: For CTV1 and CTV2, there were no significant differences in D2% between LSI and CPI. D50% and D98% were slightly higher for CPI; however, the absolute difference between the two methods was <3%. S10–S60 (in increments of 10) were significantly lower for LSI than for CPI (P < 0.001 for all parameters). LSI was associated with a significant trend toward dose reduction at the skin area irradiated with a higher dose by CPI (P < 0.001). Conclusions: LSI achieved better skin sparing than CPI without sacrificing target volume coverage in parotid tumor patients.
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spelling pubmed-74568052020-09-11 Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors Kubo, Nobuteru Kubota, Yoshiki Oike, Takahiro Kawamura, Hidemasa Sakai, Makoto Imamura, Ayaka Komatsu, Shuichiro Miyasaka, Yuhei Sato, Hiro Musha, Atsushi Okano, Naoko Shirai, Katsuyuki Saitoh, Jun-ichi Chikamatsu, Kazuaki Ohno, Tatsuya Front Oncol Oncology Background: Layer-stacking irradiation (LSI) results in the accumulation of multiple small spread-out Bragg peaks along the beam direction. Although the superiority of LSI to conventional passive irradiation (CPI) regarding normal tissue sparing is theoretically evident, the clinical benefit of LSI has not been demonstrated. Here, we compared LSI with CPI using the same treatment planning-computed tomography images used for carbon ion radiotherapy (CIRT). Methods: Twenty-one parotid tumors were analyzed. The clinical target volume (CTV) 1 and CTV2 encompassed the parotid grand and the tumor, respectively. CTV1 and CTV2 received 36 Gy (RBE: relative biological effectiveness) in nine fractions and 64 Gy (RBE) in 16 fractions, respectively, using either LSI or CPI. CTV coverage was assessed by DX%, which is the dose covering at least X% of the target volume. Skin dose was assessed by SX, which is the skin surface area receiving at least X Gy (RBE). Results: For CTV1 and CTV2, there were no significant differences in D2% between LSI and CPI. D50% and D98% were slightly higher for CPI; however, the absolute difference between the two methods was <3%. S10–S60 (in increments of 10) were significantly lower for LSI than for CPI (P < 0.001 for all parameters). LSI was associated with a significant trend toward dose reduction at the skin area irradiated with a higher dose by CPI (P < 0.001). Conclusions: LSI achieved better skin sparing than CPI without sacrificing target volume coverage in parotid tumor patients. Frontiers Media S.A. 2020-08-14 /pmc/articles/PMC7456805/ /pubmed/32923391 http://dx.doi.org/10.3389/fonc.2020.01396 Text en Copyright © 2020 Kubo, Kubota, Oike, Kawamura, Sakai, Imamura, Komatsu, Miyasaka, Sato, Musha, Okano, Shirai, Saitoh, Chikamatsu and Ohno. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Kubo, Nobuteru
Kubota, Yoshiki
Oike, Takahiro
Kawamura, Hidemasa
Sakai, Makoto
Imamura, Ayaka
Komatsu, Shuichiro
Miyasaka, Yuhei
Sato, Hiro
Musha, Atsushi
Okano, Naoko
Shirai, Katsuyuki
Saitoh, Jun-ichi
Chikamatsu, Kazuaki
Ohno, Tatsuya
Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors
title Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors
title_full Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors
title_fullStr Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors
title_full_unstemmed Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors
title_short Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors
title_sort skin dose reduction by layer-stacking irradiation in carbon ion radiotherapy for parotid tumors
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456805/
https://www.ncbi.nlm.nih.gov/pubmed/32923391
http://dx.doi.org/10.3389/fonc.2020.01396
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