Influence of Target Location, Size, and Patient Age on Normal Tissue Sparing- Proton and Photon Therapy in Paediatric Brain Tumour Patient-Specific Approach
Background: Proton radiotherapy produces superior dose distributions compared to photon radiotherapy, reducing side effects. Differences between the two modalities are not fully quantified in paediatric patients for various intracranial tumour sites or age. Understanding these differences may help c...
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| Format: | Article |
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MDPI AG
2020-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/9/2578 |
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| author | Mikaela Dell’Oro Michala Short Puthenparampil Wilson Chia-Ho Hua Melissa Gargone Thomas E. Merchant Eva Bezak |
| author_facet | Mikaela Dell’Oro Michala Short Puthenparampil Wilson Chia-Ho Hua Melissa Gargone Thomas E. Merchant Eva Bezak |
| author_sort | Mikaela Dell’Oro |
| collection | DOAJ |
| description | Background: Proton radiotherapy produces superior dose distributions compared to photon radiotherapy, reducing side effects. Differences between the two modalities are not fully quantified in paediatric patients for various intracranial tumour sites or age. Understanding these differences may help clinicians estimate the benefit and improve referral across available centres. Our aim was to compare intensity-modulated proton therapy (IMPT) and intensity-modulated photon radiotherapy (IMRT) radiation doses for select paediatric intracranial tumours. Methods: IMPT and IMRT dose distributions for gender-matched paediatric cranial CT-datasets (ages 5, 9 and 13 years) were retrospectively calculated to simulate irradiation of supratentorial (ependymoma) and infratentorial (medulloblastoma) target volumes diameters (1–3 cm) and position (central and 1–2 cm shifts). Results: Clinical dosimetric objectives were achieved for all 216 treatment plans. Whilst infratentorial IMPT plans achieved greater maximum dose sparing to optic structures (4.8–12.6 Gy optic chiasm), brainstem sparing was limited (~0.5 Gy). Mean dose difference for optic chiasm was associated with medulloblastoma target position (<i>p</i> < 0.0197). Supratentorial IMPT plans demonstrated greater dose reduction for the youngest patients (pituitary gland <i>p</i> < 0.001). Conclusions: Normal tissue sparing was achieved regardless of patient age for infratentorial tumours. However, for supratentorial tumours, there was a dosimetric advantage of IMPT across 9 vs. 13-year-old patients. |
| first_indexed | 2024-03-10T16:26:29Z |
| format | Article |
| id | doaj.art-76ba122783db402980b3656063bdc21d |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T16:26:29Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-76ba122783db402980b3656063bdc21d2023-11-20T13:12:45ZengMDPI AGCancers2072-66942020-09-01129257810.3390/cancers12092578Influence of Target Location, Size, and Patient Age on Normal Tissue Sparing- Proton and Photon Therapy in Paediatric Brain Tumour Patient-Specific ApproachMikaela Dell’Oro0Michala Short1Puthenparampil Wilson2Chia-Ho Hua3Melissa Gargone4Thomas E. Merchant5Eva Bezak6Cancer Research Institute, University of South Australia, Adelaide SA 5001, AustraliaCancer Research Institute, University of South Australia, Adelaide SA 5001, AustraliaDepartment of Radiation Oncology, Royal Adelaide Hospital, Adelaide SA 5000, AustraliaDepartment of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USADepartment of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USADepartment of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USACancer Research Institute, University of South Australia, Adelaide SA 5001, AustraliaBackground: Proton radiotherapy produces superior dose distributions compared to photon radiotherapy, reducing side effects. Differences between the two modalities are not fully quantified in paediatric patients for various intracranial tumour sites or age. Understanding these differences may help clinicians estimate the benefit and improve referral across available centres. Our aim was to compare intensity-modulated proton therapy (IMPT) and intensity-modulated photon radiotherapy (IMRT) radiation doses for select paediatric intracranial tumours. Methods: IMPT and IMRT dose distributions for gender-matched paediatric cranial CT-datasets (ages 5, 9 and 13 years) were retrospectively calculated to simulate irradiation of supratentorial (ependymoma) and infratentorial (medulloblastoma) target volumes diameters (1–3 cm) and position (central and 1–2 cm shifts). Results: Clinical dosimetric objectives were achieved for all 216 treatment plans. Whilst infratentorial IMPT plans achieved greater maximum dose sparing to optic structures (4.8–12.6 Gy optic chiasm), brainstem sparing was limited (~0.5 Gy). Mean dose difference for optic chiasm was associated with medulloblastoma target position (<i>p</i> < 0.0197). Supratentorial IMPT plans demonstrated greater dose reduction for the youngest patients (pituitary gland <i>p</i> < 0.001). Conclusions: Normal tissue sparing was achieved regardless of patient age for infratentorial tumours. However, for supratentorial tumours, there was a dosimetric advantage of IMPT across 9 vs. 13-year-old patients.https://www.mdpi.com/2072-6694/12/9/2578paediatricproton therapybrain tumourIMPTIMRTtarget size and location |
| spellingShingle | Mikaela Dell’Oro Michala Short Puthenparampil Wilson Chia-Ho Hua Melissa Gargone Thomas E. Merchant Eva Bezak Influence of Target Location, Size, and Patient Age on Normal Tissue Sparing- Proton and Photon Therapy in Paediatric Brain Tumour Patient-Specific Approach Cancers paediatric proton therapy brain tumour IMPT IMRT target size and location |
| title | Influence of Target Location, Size, and Patient Age on Normal Tissue Sparing- Proton and Photon Therapy in Paediatric Brain Tumour Patient-Specific Approach |
| title_full | Influence of Target Location, Size, and Patient Age on Normal Tissue Sparing- Proton and Photon Therapy in Paediatric Brain Tumour Patient-Specific Approach |
| title_fullStr | Influence of Target Location, Size, and Patient Age on Normal Tissue Sparing- Proton and Photon Therapy in Paediatric Brain Tumour Patient-Specific Approach |
| title_full_unstemmed | Influence of Target Location, Size, and Patient Age on Normal Tissue Sparing- Proton and Photon Therapy in Paediatric Brain Tumour Patient-Specific Approach |
| title_short | Influence of Target Location, Size, and Patient Age on Normal Tissue Sparing- Proton and Photon Therapy in Paediatric Brain Tumour Patient-Specific Approach |
| title_sort | influence of target location size and patient age on normal tissue sparing proton and photon therapy in paediatric brain tumour patient specific approach |
| topic | paediatric proton therapy brain tumour IMPT IMRT target size and location |
| url | https://www.mdpi.com/2072-6694/12/9/2578 |
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