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Radiation Oncology
Published in: Radiation Oncology 1/2008

Open Access 01-12-2008 | Research

Intensity-modulated radiotherapy of nasopharyngeal carcinoma: a comparative treatment planning study of photons and protons

Authors: Zahra Taheri-Kadkhoda, Thomas Björk-Eriksson, Simeon Nill, Jan J Wilkens, Uwe Oelfke, Karl-Axel Johansson, Peter E Huber, Marc W Münter

Published in: Radiation Oncology | Issue 1/2008

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Abstract

Background

The aim of this treatment planning study was to investigate the potential advantages of intensity-modulated (IM) proton therapy (IMPT) compared with IM photon therapy (IMRT) in nasopharyngeal carcinoma (NPC).

Methods

Eight NPC patients were chosen. The dose prescriptions in cobalt Gray equivalent (GyE) for gross tumor volumes of the primary tumor (GTV-T), planning target volumes of GTV-T and metastatic (PTV-TN) and elective (PTV-N) lymph node stations were 72.6 GyE, 66 GyE, and 52.8 GyE, respectively. For each patient, nine coplanar fields IMRT with step-and-shoot technique and 3D spot-scanned three coplanar fields IMPT plans were prepared. Both modalities were planned in 33 fractions to be delivered with a simultaneous integrated boost technique. All plans were prepared and optimized by using the research version of the inverse treatment planning system KonRad (DKFZ, Heidelberg).

Results

Both treatment techniques were equal in terms of averaged mean dose to target volumes. IMPT plans significantly improved the tumor coverage and conformation (P < 0.05) and they reduced the averaged mean dose to several organs at risk (OARs) by a factor of 2–3. The low-to-medium dose volumes (0.33–13.2 GyE) were more than doubled by IMRT plans.

Conclusion

In radiotherapy of NPC patients, three-field IMPT has greater potential than nine-field IMRT with respect to tumor coverage and reduction of the integral dose to OARs and non-specific normal tissues. The practicality of IMPT in NPC deserves further exploration when this technique becomes available on wider clinical scale.
Appendix
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Metadata
Title
Intensity-modulated radiotherapy of nasopharyngeal carcinoma: a comparative treatment planning study of photons and protons
Authors
Zahra Taheri-Kadkhoda
Thomas Björk-Eriksson
Simeon Nill
Jan J Wilkens
Uwe Oelfke
Karl-Axel Johansson
Peter E Huber
Marc W Münter
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2008
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-3-4

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