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Nathan Torelli¹, Yves Bicker¹, Louise Marc¹

¹Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Physics in medicine and biology

|June 28, 2024

概括

联合质子光子疗法 (CPPT) 优化了对转移性癌症的有限质子资源. 这种方法在单个转移中战略性地使用质子和光子剂量,提高治疗质量,同时保持质子治疗的可用性.

科学领域:

辐射瘤学辐射瘤学
医学物理医学物理
癌症治疗方法癌症治疗方法

背景情况:

质子疗法是一种有价值但有限的资源,往往无法为转移性癌症患者提供.
联合质子光子疗法 (CPPT) 提供了一种策略,通过将其与传统光子疗法相结合,来扩大质子疗法的益处.
在CPPT中优化单个质子分数的使用对于最大限度地影响转移性疾病至关重要.

研究的目的:

开发和评估一种优化的CPPT方法来治疗多个大脑或肝脏转移.
在CPPT框架内确定最佳的质子和光子剂量对单个转移的贡献.
与强度调节放射治疗 (IMRT) 单独计划和强度调节质子疗法 (IMPT) 单独计划相比,评估优化CPTT的剂量学益处.

主要方法:

同时优化强度调制质子疗法 (IMPT) 和强度调制放射疗法 (IMRT) 计划.
使用累积生物有效剂量 (BED) 作为优化目标.
将质子和光子分数的个体转移剂量贡献纳入优化变量.
在患有多重脑部和肝脏转移的患者中表现得很好.

主要成果:

优化的CPPT计划有效地增加了对大多数转移的质子剂量.
光子被战略性地用于在大型或关键结构相邻的转移周围的分化.
与IMRT-only相比,CPPT显著降低了大脑 (29%的BED2) 和肝脏 (42%的BED4) 的平均BED.
CPPT的剂量测量质量接近只有IMPT的计划.

结论:

优化的CPPT,平衡质子和光子贡献,可以增强选择转移性癌症患者的治疗.
这种方法最大限度地利用了有限的质子疗法资源.
CPPT提供了一种可行的策略,以改善多重转移患者的放射治疗结果.

关键词:

结合的质子光子疗法.强度调节的质子疗法强度调节的质子疗法强度调节的放射治疗.转移性癌症是转移性的癌症.发生多重转移.治疗计划优化治疗计划优化

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