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    Proton Arc Therapy vs Interstitial HDR Brachytherapy in Gynecologic Cancer with Parametrial/pelvic Side Wall Extension.

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    Author
    Yi, ByongYong
    Mossahebi, Sina
    Modiri, Arezoo
    Nichols, Elizabeth M
    Guerrero, Mariana
    Lamichhane, Narottam
    Mohindra, Pranshu
    Date
    2022-06-28
    Journal
    International journal of particle therapy
    Publisher
    Allen Press
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.14338/IJPT-22-00013.1
    Abstract
    Purpose: To investigate whether volumetric-modulated proton arc therapy (VPAT) plans generate comparable doses to organs at risk (OARs) compared with interstitial high-dose-rate (iHDR) brachytherapy for patients with gynecologic cancer with disease extension to parametrial/pelvic side wall, who are not eligible for the aggressive procedure. Materials and methods: VPAT delivers proton arc beams by modulated energies at the beam nozzle while maintaining the same incident energy to the gantry during the arc rotation. Plans of 10 patients previously treated with iHDR brachytherapy for high-risk clinical treatment volumes (HRCTV; 31.8-110.6 cm3; lateral dimensions, 4.2-5.6 cm) were selected and compared with VPAT plans. VPAT plans for each patient were designed using a 152- to 245-MeV range of energy-modulated proton beams. Results: HRCTV coverage of the VPAT plans was comparable to that of the iHDR plans, with V150% showing no statistical differences. On average, the V100% and V90% of VPAT plans were higher than those of the iHDR plans, 95.0% vs 91.9% (P = .02) and 98.6% vs 97.5% (P = .02), respectively. D100 was also 17% higher for the VPAT plans (P = .03). On average, the D2cm3 of bladder, rectum, and small bowels in the VPAT plans were considerably lower than those in iHDR plans (by 17.4%, 35.2%, and 65.6%, respectively; P < .05 for all OARs). Conclusion: VPAT-generated plans were dosimetrically superior to those with HDR brachytherapy with interstitial needles for locally advanced gynecologic cancer with parametrial/pelvic side wall disease extension. Dosimetrically, VPAT provides a noninvasive alternative to iHDR brachytherapy with a superior dosimetric profile.
    Rights/Terms
    ©Copyright 2022 The Author(s).
    Keyword
    interstitial brachytherapy
    locally advanced gynecologic cancer
    proton arc therapy
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/19678
    ae974a485f413a2113503eed53cd6c53
    10.14338/IJPT-22-00013.1
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