Abstract：
UNASSIGNED: Previous studies show that dose escalation for gross tumor volume (GTV) improves local control of esophageal cancer (EC). However, optimal boosting remains uncertain. Recently, functional imaging guidance to achieve dose escalation in high-risk areas of tumors has been proposed.
UNASSIGNED: This study evaluated the feasibility of dose escalation in tumor regions with high fluorodeoxyglucose (FDG) uptake using intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT).
UNASSIGNED: GTVPET was defined as a high FDG uptake region with 50% SUVmax threshold for dose escalation. IMRT and IMPT plans were generated for three boosting modes: plan 50.4 (50.4 Gy in clinical target volume, CTV), plan 63 (50.4 Gy in CTV, 63 Gy in GTV), plan 70 (50.4 Gy in CTV, 63 Gy in GTV, and 70 Gy in GTVPET).
UNASSIGNED: Eleven patients with squamous cell carcinoma were evaluated. Dose parameters for heart, lung, and spinal cord were compared based on the dose-volume histogram (DVH).
UNASSIGNED: Paired t-test was performed on the doses to organs-at-risk (OARs) among plan 50.4, plan 63, and plan 70 for IMRT and IMPT.
UNASSIGNED: Dosimetric parameters for IMRT for heart, lung, and spinal cord increased significantly for plan 63 and some parameters even exceeded dose limits for OARs. Further dose escalation in GTV-PET did not increase dosimetric parameters significantly. Most dosimetric parameters of OARs in IMPT exhibited no statistical change compared with plan 50.4, and doses to OARs were far less than dose constraints.
UNASSIGNED: Dose escalation by IMRT may lead to increased risk of radiation-related injury. Further dose escalation in high FDG uptake regions did not increase doses to OARs. This dose escalation is ideal for achieving better outcomes for EC treatment.
UNASSIGNED: This study evaluated the feasibility of dose escalation in tumor regions with high fluorodeoxyglucose (FDG) uptake using intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT).
UNASSIGNED: GTVPET was defined as a high FDG uptake region with 50% SUVmax threshold for dose escalation. IMRT and IMPT plans were generated for three boosting modes: plan 50.4 (50.4 Gy in clinical target volume, CTV), plan 63 (50.4 Gy in CTV, 63 Gy in GTV), plan 70 (50.4 Gy in CTV, 63 Gy in GTV, and 70 Gy in GTVPET).
UNASSIGNED: Eleven patients with squamous cell carcinoma were evaluated. Dose parameters for heart, lung, and spinal cord were compared based on the dose-volume histogram (DVH).
UNASSIGNED: Paired t-test was performed on the doses to organs-at-risk (OARs) among plan 50.4, plan 63, and plan 70 for IMRT and IMPT.
UNASSIGNED: Dosimetric parameters for IMRT for heart, lung, and spinal cord increased significantly for plan 63 and some parameters even exceeded dose limits for OARs. Further dose escalation in GTV-PET did not increase dosimetric parameters significantly. Most dosimetric parameters of OARs in IMPT exhibited no statistical change compared with plan 50.4, and doses to OARs were far less than dose constraints.
UNASSIGNED: Dose escalation by IMRT may lead to increased risk of radiation-related injury. Further dose escalation in high FDG uptake regions did not increase doses to OARs. This dose escalation is ideal for achieving better outcomes for EC treatment.
摘要：
UNASSIGNED：先前的研究表明，大体肿瘤体积（GTV）的剂量递增可改善食管癌（EC）的局部控制。然而,最佳提升仍不确定。最近,已经提出了在肿瘤高危区域实现剂量递增的功能成像指导。
UNASSIGNED：这项研究评估了使用调强放疗（IMRT）和调强质子治疗（IMPT）在高氟脱氧葡萄糖（FDG）摄取的肿瘤区域中剂量递增的可行性。
UNASSIGNED：GTVPET定义为高FDG摄取区域，剂量递增的SUVmax阈值为50%。针对三种增强模式生成IMRT和IMPT计划：计划50.4（临床目标体积为50.4Gy，CTV),计划63(CTV为50.4Gy，在GTV中63Gy)，计划70(CTV为50.4Gy，在GTV中63Gy，和GTVPET中的70Gy）。
UNASSIGNED：评估了11例鳞状细胞癌患者。心脏的剂量参数，肺，根据剂量-体积直方图（DVH）比较脊髓和脊髓。
UNASSIGNED：对IMRT和IMPT的计划50.4，计划63和计划70中的危险器官（OAR）剂量进行配对t检验。
UNASSIGNED：心脏IMRT的剂量测定参数，肺，对于63计划，脊髓显着增加，某些参数甚至超过了OAR的剂量限制。GTV-PET的进一步剂量递增没有显著增加剂量学参数。与计划50.4相比，IMPT中OAR的大多数剂量学参数没有统计学变化，OAR的剂量远小于剂量限制。
UNASSIGNED：通过IMRT增加剂量可能导致辐射相关损伤的风险增加。在高FDG摄取区域中的进一步剂量递增并没有增加OAR的剂量。这种剂量递增对于实现更好的EC治疗结果是理想的。
UNASSIGNED：这项研究评估了使用调强放疗（IMRT）和调强质子治疗（IMPT）在高氟脱氧葡萄糖（FDG）摄取的肿瘤区域中剂量递增的可行性。
UNASSIGNED：GTVPET定义为高FDG摄取区域，剂量递增的SUVmax阈值为50%。针对三种增强模式生成IMRT和IMPT计划：计划50.4（临床目标体积为50.4Gy，CTV),计划63(CTV为50.4Gy，在GTV中63Gy)，计划70(CTV为50.4Gy，在GTV中63Gy，和GTVPET中的70Gy）。
UNASSIGNED：评估了11例鳞状细胞癌患者。心脏的剂量参数，肺，根据剂量-体积直方图（DVH）比较脊髓和脊髓。
UNASSIGNED：对IMRT和IMPT的计划50.4，计划63和计划70中的危险器官（OAR）剂量进行配对t检验。
UNASSIGNED：心脏IMRT的剂量测定参数，肺，对于63计划，脊髓显着增加，某些参数甚至超过了OAR的剂量限制。GTV-PET的进一步剂量递增没有显著增加剂量学参数。与计划50.4相比，IMPT中OAR的大多数剂量学参数没有统计学变化，OAR的剂量远小于剂量限制。
UNASSIGNED：通过IMRT增加剂量可能导致辐射相关损伤的风险增加。在高FDG摄取区域中的进一步剂量递增并没有增加OAR的剂量。这种剂量递增对于实现更好的EC治疗结果是理想的。
