カナイ　タカユキ   金井　貴幸    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	The impact of 4DCT-ventilation imaging-guided proton therapy on stereotactic body radiotherapy for lung cancer.
掲載誌名	正式名：Radiological physics and technology 略　 称：Radiol Phys Technol ISSNコード：18650341/18650333
掲載区分	国内
巻・号・頁	13(3),pp.230-237
著者・共著者	Ieko Yoshiro, Kadoya Noriyuki, Kanai Takayuki, Nakajima Yujiro, Arai Kazuhiro, Kato Takahiro, Ito Kengo, Miyasaka Yuya, Takeda Ken, Iwai Takeo, Nemoto Kenji, Jingu Keiichi
発行年月	2020/09
概要	Functional lung avoidance during radiotherapy can help reduce pulmonary toxicity. This study assessed the potential impact of four-dimensional computed tomography (4DCT)-ventilation imaging-guided proton radiotherapy (PT) on stereotactic body radiotherapy (SBRT) by comparing it with three-dimensional conformal radiotherapy (3D-CRT) and volumetric modulated arc therapy (VMAT), which employ photon beams. Thirteen lung cancer patients who received SBRT with 3D-CRT were included in the study. 4DCT ventilation was calculated using the patients' 4DCT data, deformable image registration, and a density-change-based algorithm. Three functional treatment plans sparing the functional lung regions were developed for each patient using 3D-CRT, VMAT, and PT. The prescribed doses and dose constraints were based on the Radiation Therapy Oncology Group 0618 protocol. We evaluated the region of interest (ROI) and functional map-based dose-function metrics for 4DCT ventilation and the irradiated dose. Using 3D-CRT, VMAT, and PT, the percentages of the functional lung regions that received ≥ 5 Gy (fV5) were 26.0%, 21.9%, and 10.7%, respectively; the fV10 were 14.4%, 11.4%, and 9.0%, respectively; and fV20 were 6.5%, 6.4%, and 6.6%, respectively, and the functional mean lung doses (fMLD) were 5.6 Gy, 5.2 Gy, and 3.8 Gy, respectively. These results indicated that PT resulted in a significant reduction in fMLD, fV5, and fV10, but not fV20. The use of PT reduced the radiation to highly functional lung regions compared with those for 3D-CRT and VMAT while meeting all dose constraints.
DOI	10.1007/s12194-020-00572-5
PMID	32537735