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Updated: Jul 24, 2025
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Published on: February 6, 2019
Comparison of Craniospinal Irradiation Using Proton Beams According to Irradiation Method and Initial Experience
Nobuyoshi Fukumitsu1, Hikaru Kubota1, Masayuki Mima1
1Departments of Radiation Oncology.
Purpose:
This study compared craniospinal irradiation using proton beam therapy (PBT) according to irradiation method and investigated the initial effects.
Methods And Materials:
Twenty-four pediatric patients (1-24 years old) who received proton craniospinal irradiation were examined. Passive scattered PBT (PSPT) and intensity modulated PBT (IMPT) were used in 8 and 16 patients, respectively. The whole vertebral body technique was used for 13 patients <10 years old, and the vertebral body sparing (VBS) technique was used for the remaining 11 patients aged ≥10 years. The follow-up period was 17 to 44 (median, 27) months. Organ-at-risk and planning target volume (PTV) doses and other clinical data were examined.
Results:
The maximum lens dose using IMPT was lower than that using PSPT (P = .008). The mean thyroid, lung, esophagus, and kidney doses were lower in patients treated using the VBS technique compared with the whole vertebral body technique (all P < .001). The minimum PTV dose of IMPT was higher than that of PSPT (P = .01). The inhomogeneity index of IMPT was lower than that of PSPT (P = .004).
Conclusions:
IMPT is better than PSPT at reducing the dose to the lens. The VBS technique can decrease the doses to neck-chest-abdomen organs. The PTV coverage of IMPT is superior to that of PSPT.
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