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作者

Tengxiang Li, Xinsen Yao, Ruimin He, Xian Xue, Shuai Wang, Jinhu Chen, Qingtao Qiu, Yong Yin, Quan Tang

作者单位

Affiliations ¹ School of Nuclear Science and Technology, University of South China, Hengyang, China. ² Department of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China. ³ Department of Radiotherapy Center, Chenzhou NO People's Hospital, Chenzhou, China. ⁴ Department of Oncology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China. ⁵ Institute of Radiation Protection and Nuclear Safety Medicine, Chinese Center for Disease Control and Prevention, Beijing, China. ⁶ Department of Radiation Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China. ⁷ University of Science and Technology of China (USTC), School of Nuclear Science and Technology (SNST), Hefei, Anhui, China.

刊名

Frontiers in oncology

年份

2025

卷号

Vol.15

页码

1474327

ISSN

2234-943X

关键词

bulky tumor centralized/core ablative proton radiation therapy stereotactic.

摘要

Objective: Stereotactic centralized/core ablative radiation therapy is a novel radiotherapy approach. This study investigates the potential benefits of proton-based SCART by leveraging the dosimetric advantages of protons and integrating them with the SCART technique. Methods: Five clinical cases previously treated with conventional proton therapy were selected for this study. The pSCART plans utilized a relative biological effectiveness prescription dose of 24 Gy × 3 fractions, with each pl...更多

Objective: Stereotactic centralized/core ablative radiation therapy is a novel radiotherapy approach. This study investigates the potential benefits of proton-based SCART by leveraging the dosimetric advantages of protons and integrating them with the SCART technique. Methods: Five clinical cases previously treated with conventional proton therapy were selected for this study. The pSCART plans utilized a relative biological effectiveness prescription dose of 24 Gy × 3 fractions, with each plan consisting of three to five fields. The prescribed dose for the CyberKnife SCART was the highest value meeting the organs-at-risk dose limits and the tumor edge dose limits. The dose distributions of the CyberKnife-based SCART and pSCART plans were compared using five criteria: i) prescription dose; ii) 80% prescription dose volume, targets coverage at 80% and 20% dose levels, and the 80%/20% ratio; iii) volume receiving >5 Gy outside the tumor edge; iv) dose tolerance limits to OARs; and v) mean dose to OARs. Results: pSCART can deliver a higher prescription dose of 24 Gy × 3 fractions versus SCART's 15 Gy × 2-3 fractions or 18 Gy × 2 fractions. Specifically, pSCART outperforms SCART in terms of the 80% prescription dose volume and 80% dose level coverage of stereotactic centralized/core target volumes achieving 69.77%-100.00% versus SCART's 43.6%-99.5%. The 20% dose level coverage for gross target volume is slightly lower for pSCART, achieving 88.96%-98.64% versus SCART's 90.1%-99.9%. The maximum point dose outside the target volume is lower for pSCART at 4.58-6.19 Gy versus SCART's 4.78-6.67 Gy; additionally, the V at the tumor edge is significantly smaller for pSCART at 5.93-23.72 cm versus SCART's 6.85-151.66 cm. The average dose to most OARs in the pSCART plan is lower than in the SCART plan. Conclusions: This work provides initial insights into evaluating treatment plans for bulky tumors using pSCART. Compared to the CyberKnife SCART, pSCART generates significantly higher prescription doses and larger high-dose regions within the GTV while delivering lower doses at the tumor edge, enhancing normal tissue sparing.收起

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