Small bowel: IMXT: 13.4 Gy, 3D CPT 7.1 Gy, IMPT 5.8 Gy
This is the largest treatment planning study for retroperitoneal sarcomas to date.
IMPT, 3D CPT, and IMXT provide excellent target coverage within normal tissue constraints, to doses of 50.4 Gy.
IMPT and IMXT plans result in higher inhomogeneity within the target, but all techniques yield clinically acceptable outcomes.
IMPT achieves the closest conformity.
IMPT and 3D CPT provide the lowest radiation dose to organs at risk.
Selective dose escalation to retroperitoneal margins of tumors was achievable with IMPT.
This dosimetric study compared IMXT with either standard 3D proton planning or IMPT for management of retroperitoneal sarcomas. This is a traditionally very difficult tumor type and body site to treat with radiotherapy, given the large, complex target volumes near organs at risk.
IMPT using scanning proton therapy is the next generation of highly conformal radiotherapy. Not only is IMPT more conformal, it is also associated with lower neutron contamination than either IMXT or passive scattering proton therapy.
Several centers in the U.S. are preparing to use IMPT with scanning proton therapy, but its availability will be limited in the next several years.
Long-term clinical data on patients treated with IMPT will be required to determine if these dosimetric gains can be translated into clinical gains
Apr 18, 2012 - For patients with nonmetastatic prostate cancer, treatment with intensity-modulated radiation therapy is associated with fewer complications than proton therapy or conformal radiation therapy, according to a study published in the April 18 issue of the Journal of the American Medical Association, a theme issue on comparative effectiveness research.