Dosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma

Purpose: To compare the dosimetric differences in stereotactic radiosurgery between use of passively scattered protons (PSRS) versus photons (XSRS) for pituitary adenomas. Methods and Materials: Nine patients with pituitary adenomas were selected among patients receiving single-fraction proton stere...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Shivani Sud, MD, Thomas Botticello, BS, CMD, Andrzej Niemierko, PhD, Jillian Daly, BS, CMD, Marc Bussiere, MS, Helen A Shih, MD, MS, MPH
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/5645341676b64ac1aa38df22d996246a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:5645341676b64ac1aa38df22d996246a
record_format	dspace
spelling	oai:doaj.org-article:5645341676b64ac1aa38df22d996246a2021-11-06T04:33:05ZDosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma2452-109410.1016/j.adro.2021.100806https://doaj.org/article/5645341676b64ac1aa38df22d996246a2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2452109421001640https://doaj.org/toc/2452-1094Purpose: To compare the dosimetric differences in stereotactic radiosurgery between use of passively scattered protons (PSRS) versus photons (XSRS) for pituitary adenomas. Methods and Materials: Nine patients with pituitary adenomas were selected among patients receiving single-fraction proton stereotactic radiosurgery (PSRS) between 2016 and 2017. These cases were replanned with XSRS using volumetric-modulated arc therapy with 2.5 mm and 5 mm multileaf collimators (2.5XSRS and 5XSRS, respectively). PSRS was planned with a dedicated single scattering stereotactic proton unit delivered via 3 equally or unequally weighted isocentric fields. XSRS plans were created with optimization to spare organs at risk. Plans were generated using the original total treatment dose delivered in 1 fraction. Results: Plans were evaluated for target volume dosimetry and estimated clinical toxicity. There was no significant difference in clinical target volume V100%, V95%, V90% or homogeneity index between treatment modalities. PSRS offered lower maximum dose (Dmax) to organs at risk and equivalent uniform dose (EUD) compared with 5XSRS and 2.5XSRS, respectively, for critical structures including optic nerve (right, Dmax 4.18, 5.32, 5.41; EUD 3.35, 4.08, 4.20) and hypothalamus (Dmax 1.71, 3.94, 3.77; EUD 0.94, 2.47, 2.39; P < .05 for PSRS vs 5XSRS and 2.5XSRS). The projected risk of secondary tumors in excess of baseline was lowest for PSRS plans (PSRS 5.28, 5XSRS 12.93, 2.5XSRS 12.66 cases per 10,000 patient-years; P = .008 for PSRS vs 5XSRS, PSRS vs 2.5XSRS, and P = .77 for 5XSRS vs 2.5XSRS). Conclusions: We demonstrate that neither modality has empirically superior dosimetry and identify potential clinical advantages as well as limitations of each technique. PSRS, 5XSRS and 2.5XSRS demonstrate comparable target volume dosimetry for pituitary adenoma. PSRS compared with XSRS modalities offers modestly decreased maximum dose and EUD to critical proximal structures and decreases risk of radiation-induced secondary tumors by more than half.Shivani Sud, MDThomas Botticello, BS, CMDAndrzej Niemierko, PhDJillian Daly, BS, CMDMarc Bussiere, MSHelen A Shih, MD, MS, MPHElsevierarticleMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENAdvances in Radiation Oncology, Vol 6, Iss 6, Pp 100806- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Shivani Sud, MD Thomas Botticello, BS, CMD Andrzej Niemierko, PhD Jillian Daly, BS, CMD Marc Bussiere, MS Helen A Shih, MD, MS, MPH Dosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma
description	Purpose: To compare the dosimetric differences in stereotactic radiosurgery between use of passively scattered protons (PSRS) versus photons (XSRS) for pituitary adenomas. Methods and Materials: Nine patients with pituitary adenomas were selected among patients receiving single-fraction proton stereotactic radiosurgery (PSRS) between 2016 and 2017. These cases were replanned with XSRS using volumetric-modulated arc therapy with 2.5 mm and 5 mm multileaf collimators (2.5XSRS and 5XSRS, respectively). PSRS was planned with a dedicated single scattering stereotactic proton unit delivered via 3 equally or unequally weighted isocentric fields. XSRS plans were created with optimization to spare organs at risk. Plans were generated using the original total treatment dose delivered in 1 fraction. Results: Plans were evaluated for target volume dosimetry and estimated clinical toxicity. There was no significant difference in clinical target volume V100%, V95%, V90% or homogeneity index between treatment modalities. PSRS offered lower maximum dose (Dmax) to organs at risk and equivalent uniform dose (EUD) compared with 5XSRS and 2.5XSRS, respectively, for critical structures including optic nerve (right, Dmax 4.18, 5.32, 5.41; EUD 3.35, 4.08, 4.20) and hypothalamus (Dmax 1.71, 3.94, 3.77; EUD 0.94, 2.47, 2.39; P < .05 for PSRS vs 5XSRS and 2.5XSRS). The projected risk of secondary tumors in excess of baseline was lowest for PSRS plans (PSRS 5.28, 5XSRS 12.93, 2.5XSRS 12.66 cases per 10,000 patient-years; P = .008 for PSRS vs 5XSRS, PSRS vs 2.5XSRS, and P = .77 for 5XSRS vs 2.5XSRS). Conclusions: We demonstrate that neither modality has empirically superior dosimetry and identify potential clinical advantages as well as limitations of each technique. PSRS, 5XSRS and 2.5XSRS demonstrate comparable target volume dosimetry for pituitary adenoma. PSRS compared with XSRS modalities offers modestly decreased maximum dose and EUD to critical proximal structures and decreases risk of radiation-induced secondary tumors by more than half.
format	article
author	Shivani Sud, MD Thomas Botticello, BS, CMD Andrzej Niemierko, PhD Jillian Daly, BS, CMD Marc Bussiere, MS Helen A Shih, MD, MS, MPH
author_facet	Shivani Sud, MD Thomas Botticello, BS, CMD Andrzej Niemierko, PhD Jillian Daly, BS, CMD Marc Bussiere, MS Helen A Shih, MD, MS, MPH
author_sort	Shivani Sud, MD
title	Dosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma
title_short	Dosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma
title_full	Dosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma
title_fullStr	Dosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma
title_full_unstemmed	Dosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma
title_sort	dosimetric comparison of proton versus photon radiosurgery for treatment of pituitary adenoma
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/5645341676b64ac1aa38df22d996246a
work_keys_str_mv	AT shivanisudmd dosimetriccomparisonofprotonversusphotonradiosurgeryfortreatmentofpituitaryadenoma AT thomasbotticellobscmd dosimetriccomparisonofprotonversusphotonradiosurgeryfortreatmentofpituitaryadenoma AT andrzejniemierkophd dosimetriccomparisonofprotonversusphotonradiosurgeryfortreatmentofpituitaryadenoma AT jilliandalybscmd dosimetriccomparisonofprotonversusphotonradiosurgeryfortreatmentofpituitaryadenoma AT marcbussierems dosimetriccomparisonofprotonversusphotonradiosurgeryfortreatmentofpituitaryadenoma AT helenashihmdmsmph dosimetriccomparisonofprotonversusphotonradiosurgeryfortreatmentofpituitaryadenoma
_version_	1718443852948307968

Dosimetric Comparison of Proton Versus Photon Radiosurgery for Treatment of Pituitary Adenoma

Ejemplares similares