scholarly journals Early clinical outcomes of helical tomotherapy/intensity‐modulated proton therapy combination in nasopharynx cancer

2019 ◽  
Vol 110 (9) ◽  
pp. 2867-2874 ◽  
Author(s):  
Seung Gyu Park ◽  
Yong Chan Ahn ◽  
Dongryul Oh ◽  
Jae Myoung Noh ◽  
Sang Gyu Ju ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Proton Therapy ◽  
Helical Tomotherapy ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Nasopharynx Cancer ◽  
Early Clinical Outcomes

scholarly journals Early Clinical Outcomes by Combination of Intensity Modulated Radiation Therapy and Intensity Modulated Proton Therapy in Treating Oropharynx Cancer Patients

2021 ◽  
Author(s):  
Han Gyul Yoon ◽  
Yong Chan Ahn ◽  
Dongryul Oh ◽  
Jae Myoung Noh ◽  
Seung Kyu Park ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Clinical Outcomes ◽  
Proton Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Combination Group ◽  
Intensity Modulated Proton Therapy ◽  
Oropharynx Cancer ◽  
Intensity Modulated ◽  
Before And After ◽  
Early Clinical Outcomes

Purpose: To report the early clinical outcomes of combining intensity‐modulated radiation therapy (IMRT) and intensity‐modulated proton therapy (IMPT) in comparison with IMRT alone in treating the oropharynx cancer (OPC) patients. Materials and Methods: The medical records of 148 OPC patients were retrospectively reviewed, who underwent definitive radiotherapy (RT) with concurrent systemic therapy, from January 2016 till December 2019 at Samsung Medical Center. During the 5.5 weeks’ RT course, the initial 16 (or 18) fractions were delivered by IMRT in all patients, and the subsequent 12 (or 10) fractions were either by IMRT in 81 patients (IMRT only) or by IMPT in 67 (IMRT/IMPT combination), respectively, based on comparison of adaptive re-plan profiles and availability of equipment. Propensity‐score matching (PSM) was done on 76 patients (38 from each group) for comparative analyses. Results: With the median follow‐up of 24.7 months, there was no significant difference in overall survival and progression free survival between groups, both before and after PSM. Before PSM, IMRT/IMPT combination group experienced grade ≥3 acute toxicities less frequently: mucositis in 37.0% and 13.4% (p<0.001); and analgesic quantification algorithm (AQA) in 37.0% and 19.4% (p=0.019), respectively. The same trends were observed after PSM: mucositis in 39.5% and 15.8% (p=0.021); and AQA in 47.4% and 21.1% (p=0.016), respectively. In multivariate logistic regression, grade ≥3 mucositis was significantly less frequent in IMRT/IMPT combination group, both before and after PSM (p=0.027 and 0.024, respectively). AQA score ≥3 was also less frequent in IMRT/IMPT combination group, both before and after PSM (p=0.085 and 0.018, respectively). Conclusions: In treating the OPC patients, with comparable early oncologic outcomes, more favorable acute toxicity profiles were achieved following IMRT/IMPT combination than IMRT alone.

scholarly journals Early Clinical Outcomes of Intensity Modulated Radiation Therapy/Intensity Modulated Proton Therapy Combination in Comparison with Intensity Modulated Radiation Therapy Alone in Oropharynx Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1549
Author(s):  
Han Gyul Yoon ◽  
Yong Chan Ahn ◽  
Dongryul Oh ◽  
Jae Myoung Noh ◽  
Seung Gyu Park ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Proton Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Combination Group ◽  
Intensity Modulated Proton Therapy ◽  
Oropharynx Cancer ◽  
Intensity Modulated ◽  
Before And After ◽  
Grade 3 ◽  
Early Clinical Outcomes

Purpose: To report the early clinical outcomes of combining intensity-modulated radiation therapy (IMRT) and intensity-modulated proton therapy (IMPT) in comparison with IMRT alone in treating oropharynx cancer (OPC) patients. Materials and Methods: The medical records of 148 OPC patients who underwent definitive radiotherapy (RT) with concurrent systemic therapy, from January 2016 till December 2019 at Samsung Medical Center, were retrospectively reviewed. During the 5.5 weeks’ RT course, the initial 16 (or 18) fractions were delivered by IMRT in all patients, and the subsequent 12 (or 10) fractions were either by IMRT in 81 patients (IMRT only) or by IMPT in 67 (IMRT/IMPT combination), respectively, based on comparison of adaptive re-plan profiles and availability of equipment. Propensity-score matching (PSM) was done on 76 patients (38 from each group) for comparative analyses. Results: With the median follow-up of 24.7 months, there was no significant difference in overall survival and progression free survival between groups, both before and after PSM. Before PSM, the IMRT/IMPT combination group experienced grade ≥ 3 acute toxicities less frequently: mucositis in 37.0% and 13.4% (p < 0.001); and analgesic quantification algorithm (AQA) in 37.0% and 19.4% (p = 0.019), respectively. The same trends were observed after PSM: mucositis in 39.5% and 15.8% (p = 0.021); and AQA in 47.4% and 21.1% (p = 0.016), respectively. In multivariate logistic regression, grade ≥ 3 mucositis was significantly less frequent in the IMRT/IMPT combination group, both before and after PSM (p = 0.027 and 0.024, respectively). AQA score ≥ 3 was also less frequent in the IMRT/IMPT combination group, both before and after PSM (p = 0.085 and 0.018, respectively). Conclusions: In treating the OPC patients, with comparable early oncologic outcomes, more favorable acute toxicity profiles were achieved following IMRT/IMPT combination than IMRT alone.

scholarly journals Dosimetric Comparison of Helical Tomotherapy and Intensity-Modulated Proton Therapy in Hippocampus- and Scalp-Sparing Whole Brain Radiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382110601
Author(s):  
Taiki Takaoka ◽  
Natsuo Tomita ◽  
Tomoki Mizuno ◽  
Shingo Hashimoto ◽  
Takahiro Tsuchiya ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Proton Therapy ◽  
Helical Tomotherapy ◽  
Whole Brain Radiotherapy ◽  
Conformity Index ◽  
Target Dose ◽  
Whole Brain ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Brain Radiotherapy

Objective: Cognitive decline and alopecia after radiotherapy are challenging problems. We aimed to compare whole brain radiotherapy (WBRT) plans reducing radiation dose to the hippocampus and scalp between helical tomotherapy (HT) and intensity-modulated proton therapy (IMPT). Methods: We conducted a planning study of WBRT for 10 patients. The clinical target volume was defined as the whole brain excluding the hippocampus avoidance (HA) region. The prescribed dose was 30 Gy in 10 fractions to cover 95% of the target. Constraint goals were defined for the target and organs at risk (OAR). Results: Both techniques met the dose constraints for the target and OAR. However, the coverage of the target (dose covering 95% [D95%] and 98% [D98%] of the volume) were better in IMPT than HT (HT vs IMPT: D95%, 29.9 Gy vs 30.0 Gy, P < .001; D98%, 26.7 Gy vs 28.1 Gy, P = .002). The homogeneity and conformity of the target were also better in IMPT than HT (HT vs IMPT: homogeneity index, 1.50 vs 1.28, P < .001; conformity index, 1.30 vs 1.14, P < .001). IMPT reduced the D100% of the hippocampus by 59% (HT vs IMPT: 9.3 Gy vs 3.8 Gy, P < .001) and reduced the Dmean of the hippocampus by 37% (HT vs IMPT: 11.1 Gy vs 7.0 Gy, P < .001) compared with HT. The scalp IMPT reduced the percentage of the volume receiving at least 20 Gy (V20Gy) and V10Gy compared with HT (HT vs IMPT: V20Gy, 56.7% vs 6.6%, P < .001; V10Gy, 90.5% vs 37.1%, P < .001). Conclusion: Both techniques provided acceptable target dose coverage. Especially, IMPT achieved excellent hippocampus- and scalp-sparing. HA-WBRT using IMPT is a promising treatment to prevent cognitive decline and alopecia.

Helical tomotherapy and intensity modulated proton therapy in the treatment of dominant intraprostatic lesion: A treament planning comparison

2013 ◽  
Vol 107 (2) ◽  
pp. 207-212 ◽  
Author(s):  
Francesco Fellin ◽  
Raffaella Azzeroni ◽  
Angelo Maggio ◽  
Stefano Lorentini ◽  
Cesare Cozzarini ◽  
...  
Keyword(s):  
Proton Therapy ◽  
Helical Tomotherapy ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated

Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

Head & Neck ◽  
2015 ◽  
Vol 38 (S1) ◽  
pp. E1886-E1895 ◽  
Author(s):  
Gary D. Lewis ◽  
Emma B. Holliday ◽  
Esengul Kocak-Uzel ◽  
Mike Hernandez ◽  
Adam S. Garden ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Radiation Dose ◽  
Clinical Outcomes ◽  
Proton Therapy ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated
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