Pencil-beam scanning proton therapy for anal cancer: a dosimetric comparison with intensity-modulated radiotherapy

Acta Oncologica
Eric OjerholmJohn P Plastaras

Abstract

Concurrent chemoradiotherapy cures most patients with anal squamous cell carcinoma at the cost of significant treatment-related toxicities. Intensity-modulated radiotherapy (IMRT) reduces side effects compared to older techniques, but whether proton beam therapy (PBT) offers additional advantages is unclear. Eight patients treated with PBT for anal cancer were chosen for this study. We conducted detailed plan comparisons between pencil-beam scanning PBT via two posterior oblique fields and seven-field IMRT. Cumulative dose-volume histograms were analyzed by Wilcoxon signed-rank test, and plan delivery robustness was assessed via verification computed tomography (CT) scans obtained during treatment. Compared to IMRT, PBT reduced low dose radiation (≤ 30 Gy) to the small bowel, total pelvic bone marrow, external genitalia, femoral heads, and bladder (all p < 0.05) without compromising target coverage. For PBT versus IMRT, mean small bowel volume receiving ≥ 15 Gy (V15) was 81 versus 151 cm(3), mean external genitalia V20 was 14 versus 40%, and mean total pelvic bone marrow V15 was 66 versus 83% (all p = 0.008). The lumbosacral bone marrow dose was higher with PBT due to beam geometry. PBT was delivered with ≤ 1.3% interfraction d...Continue Reading

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Feb 21, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Jennifer VogelCharles B Simone
Feb 2, 2016·Cancer Treatment Reviews·Jérôme DoyenJean-Michel Hannoun-Lévi
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Apr 4, 2021·Cancers·Edward Christopher DeeJennifer Y Wo
Aug 3, 2021·Surgical Oncology·Matthew FokDale Vimalachandran

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