Dosimetric comparison of intensity modulated proton therapy and intensity modulated radiotherapy in primary mediastinal B-cell lymphoma
Keywords:
Dosimetric study, Non-Hodgkin’s lymphoma, Proton therapy, IMPTAbstract
Backgrounds
Non-Hodgkin lymphoma is a hematologic disease with excellent outcome after chemotherapy and radiotherapy. However, a patient undergoing radiotherapy is at risk of developing late toxicities such as myocardial infraction, congestive heart failure and radiation pneumonitis which varies according to radiation doses to organs at risk. This study compares the dosimetry of intensity modulated proton therapy (IMPT) with the intensity modulated radiation therapy (IMRT).
Objective
To compare the dosimetry between IMPT and IMRT in patients with primary mediastinal B-cell lymphoma (PMBCL) and measure the difference in target dose coverage, heterogeneity, conformity, and doses to organs at risks.
Material and Methods
Computed tomography (CT) of 12 patients with PMBCL were re-planned with IMRT and IMPT techniques with the prescribed dose of 45 Gy in 25 fractions, which required to covered 95% of PTV in IMRT and 98% of CTV in IMPT. Both plans were compared and evaluated.
Result
Both plans achieved adequate target coverage (98% of CTV for IMPT and 95% of PTV for IMRT). IMPT minimized mean heart, lung, and esophagus doses, with the mean heart and lung dose staying within the QUANTEC threshold. Additionally, IMPT showed better homogeneity but worse conformity when compared to IMRT.
Conclusion
IMPT reduced the radiation doses to organs at risk while achieving adequate target coverage, which might translate to lower acute and late toxicities.
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