Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors
Background: Layer-stacking irradiation (LSI) results in the accumulation of multiple small spread-out Bragg peaks along the beam direction. Although the superiority of LSI to conventional passive irradiation (CPI) regarding normal tissue sparing is theoretically evident, the clinical benefit of LSI...
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Frontiers Media S.A.
2020-08-01
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doaj-728c8292ab024ff3a78b82dfa54c2a5e2020-11-25T03:36:21ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-08-011010.3389/fonc.2020.01396527809Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid TumorsNobuteru Kubo0Yoshiki Kubota1Takahiro Oike2Hidemasa Kawamura3Makoto Sakai4Ayaka Imamura5Shuichiro Komatsu6Yuhei Miyasaka7Hiro Sato8Atsushi Musha9Naoko Okano10Katsuyuki Shirai11Katsuyuki Shirai12Jun-ichi Saitoh13Jun-ichi Saitoh14Kazuaki Chikamatsu15Tatsuya Ohno16Gunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanDepartment of Radiology, Saitama Medical Center, Jichi Medical University, Omiya-Ku, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanDepartment of Radiation Oncology, Faculty of Medicine, University of Toyama, Toyama, JapanDepartment of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi, JapanGunma University Heavy Ion Medical Center, Maebashi, JapanBackground: Layer-stacking irradiation (LSI) results in the accumulation of multiple small spread-out Bragg peaks along the beam direction. Although the superiority of LSI to conventional passive irradiation (CPI) regarding normal tissue sparing is theoretically evident, the clinical benefit of LSI has not been demonstrated. Here, we compared LSI with CPI using the same treatment planning-computed tomography images used for carbon ion radiotherapy (CIRT).Methods: Twenty-one parotid tumors were analyzed. The clinical target volume (CTV) 1 and CTV2 encompassed the parotid grand and the tumor, respectively. CTV1 and CTV2 received 36 Gy (RBE: relative biological effectiveness) in nine fractions and 64 Gy (RBE) in 16 fractions, respectively, using either LSI or CPI. CTV coverage was assessed by DX%, which is the dose covering at least X% of the target volume. Skin dose was assessed by SX, which is the skin surface area receiving at least X Gy (RBE).Results: For CTV1 and CTV2, there were no significant differences in D2% between LSI and CPI. D50% and D98% were slightly higher for CPI; however, the absolute difference between the two methods was <3%. S10–S60 (in increments of 10) were significantly lower for LSI than for CPI (P < 0.001 for all parameters). LSI was associated with a significant trend toward dose reduction at the skin area irradiated with a higher dose by CPI (P < 0.001).Conclusions: LSI achieved better skin sparing than CPI without sacrificing target volume coverage in parotid tumor patients.https://www.frontiersin.org/article/10.3389/fonc.2020.01396/fullcarbon ion radiotherapyhead and neck tumorslayer-stacking irradiationparotid tumorsradiation dermatitisdose surface-area histogram |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nobuteru Kubo Yoshiki Kubota Takahiro Oike Hidemasa Kawamura Makoto Sakai Ayaka Imamura Shuichiro Komatsu Yuhei Miyasaka Hiro Sato Atsushi Musha Naoko Okano Katsuyuki Shirai Katsuyuki Shirai Jun-ichi Saitoh Jun-ichi Saitoh Kazuaki Chikamatsu Tatsuya Ohno |
spellingShingle |
Nobuteru Kubo Yoshiki Kubota Takahiro Oike Hidemasa Kawamura Makoto Sakai Ayaka Imamura Shuichiro Komatsu Yuhei Miyasaka Hiro Sato Atsushi Musha Naoko Okano Katsuyuki Shirai Katsuyuki Shirai Jun-ichi Saitoh Jun-ichi Saitoh Kazuaki Chikamatsu Tatsuya Ohno Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors Frontiers in Oncology carbon ion radiotherapy head and neck tumors layer-stacking irradiation parotid tumors radiation dermatitis dose surface-area histogram |
author_facet |
Nobuteru Kubo Yoshiki Kubota Takahiro Oike Hidemasa Kawamura Makoto Sakai Ayaka Imamura Shuichiro Komatsu Yuhei Miyasaka Hiro Sato Atsushi Musha Naoko Okano Katsuyuki Shirai Katsuyuki Shirai Jun-ichi Saitoh Jun-ichi Saitoh Kazuaki Chikamatsu Tatsuya Ohno |
author_sort |
Nobuteru Kubo |
title |
Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors |
title_short |
Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors |
title_full |
Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors |
title_fullStr |
Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors |
title_full_unstemmed |
Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors |
title_sort |
skin dose reduction by layer-stacking irradiation in carbon ion radiotherapy for parotid tumors |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2020-08-01 |
description |
Background: Layer-stacking irradiation (LSI) results in the accumulation of multiple small spread-out Bragg peaks along the beam direction. Although the superiority of LSI to conventional passive irradiation (CPI) regarding normal tissue sparing is theoretically evident, the clinical benefit of LSI has not been demonstrated. Here, we compared LSI with CPI using the same treatment planning-computed tomography images used for carbon ion radiotherapy (CIRT).Methods: Twenty-one parotid tumors were analyzed. The clinical target volume (CTV) 1 and CTV2 encompassed the parotid grand and the tumor, respectively. CTV1 and CTV2 received 36 Gy (RBE: relative biological effectiveness) in nine fractions and 64 Gy (RBE) in 16 fractions, respectively, using either LSI or CPI. CTV coverage was assessed by DX%, which is the dose covering at least X% of the target volume. Skin dose was assessed by SX, which is the skin surface area receiving at least X Gy (RBE).Results: For CTV1 and CTV2, there were no significant differences in D2% between LSI and CPI. D50% and D98% were slightly higher for CPI; however, the absolute difference between the two methods was <3%. S10–S60 (in increments of 10) were significantly lower for LSI than for CPI (P < 0.001 for all parameters). LSI was associated with a significant trend toward dose reduction at the skin area irradiated with a higher dose by CPI (P < 0.001).Conclusions: LSI achieved better skin sparing than CPI without sacrificing target volume coverage in parotid tumor patients. |
topic |
carbon ion radiotherapy head and neck tumors layer-stacking irradiation parotid tumors radiation dermatitis dose surface-area histogram |
url |
https://www.frontiersin.org/article/10.3389/fonc.2020.01396/full |
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