Comparison of adverse effects of proton and X-ray chemoradiotherapy for esophageal cancer using an adaptive dose-volume histogram analysis

Journal of Radiation Research
Hirokazu MakishimaHideyuki Sakurai

Abstract

Cardiopulmonary late toxicity is of concern in concurrent chemoradiotherapy (CCRT) for esophageal cancer. The aim of this study was to examine the benefit of proton beam therapy (PBT) using clinical data and adaptive dose-volume histogram (DVH) analysis. The subjects were 44 patients with esophageal cancer who underwent definitive CCRT using X-rays (n = 19) or protons (n = 25). Experimental recalculation using protons was performed for the patient actually treated with X-rays, and vice versa. Target coverage and dose constraints of normal tissues were conserved. Lung V5-V20, mean lung dose (MLD), and heart V30-V50 were compared for risk organ doses between experimental plans and actual treatment plans. Potential toxicity was estimated using protons in patients actually treated with X-rays, and vice versa. Pulmonary events of Grade ≥2 occurred in 8/44 cases (18%), and cardiac events were seen in 11 cases (25%). Risk organ doses in patients with events of Grade ≥2 were significantly higher than for those with events of Grade ≤1. Risk organ doses were lower in proton plans compared with X-ray plans. All patients suffering toxicity who were treated with X-rays (n = 13) had reduced predicted doses in lung and heart using protons, wh...Continue Reading

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Citations

Feb 6, 2016·Current Oncology Reports·Makoto ShinotoShigeru Yamada
Feb 2, 2016·Cancer Treatment Reviews·Jérôme DoyenJean-Michel Hannoun-Lévi
Apr 17, 2016·International Journal of Radiation Oncology, Biology, Physics·Michael D ChuongSteven H Lin
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Aug 28, 2021·Journal of Personalized Medicine·Yoshitaka MatsumotoHideyuki Sakurai

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Methods Mentioned

BETA
X-ray

Software Mentioned

MIM Maestro
Xio
R Project

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