Table 1.
Dosimetric analyses of proton therapy for regional nodal irradiation (RNI).
| Author | Technique | Laterality | Target | Heart | Lung | Contralateral Breast | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||||||||||
| Ares (27) | 3D 1M IP |
Left (n=20) WB (n=10) CW (n=10) | Metric (% Rx Dose) | 3D | IM | IP | Metric (% Rx Dose) | 3D | IM | IP | Metric (% Rx Dose) | 3D | IM | IP | Metric (%Rx Dose) | 3D | IM | IP |
| Max | 121* | 112 | 109 | Mean | 19 | 19 | 4 | L Mean | 41 | 26 | 14 | Max | 15–84 | 42 | 12 | |||
| Mean | 102 | 101 | 101 | V22.5 | 11 | 8 | 8 | LV20 | 39 | 21 | 15 | Mean | 3 | 10 | 0 | |||
| Min | 94 | 93 | 98 | V5 | 40 | 68 | 12 | LV5 | 76 | 80 | 28 | |||||||
| D95 | 94 | 93 | 98 | R Mean | 3(CW) 55 (WB) | 13 | 1 | |||||||||||
| V95 | 95 | 2 | 100 | R V20 | 0 | 1 | 1 | |||||||||||
| VI07 | 17 | 2 | 1 | RV5 | 1 | 63 | 1 | |||||||||||
| Hernandez | VM | Left (n=8) | Metric (%Rx | VM | PP | IP | Metric (%Rx | VM | PP | IP | Metric | VM | PP | IP | Metric | VM | PP | IP |
| (28) | PP IP |
Dose) | Dose) | (%Rx Dose) | (%Rx Dose) | |||||||||||||
| D95 (Gy) | 47.8 | 48.6# | 49.4 | V5 | 88 | 2.02 | 3.05 | V5 | 53.2 | 13.1 | 19.0 | V5 | 57 | 0.99 2.1 | ||||
| V107 | 0.2 | 0.1 | 0.003 | V22.5 | 12 | 0.49 | 0.56 | V20 | 14.7 | 8.73 | 8.72 | Mean | 7.3 | 0.17 0.34 | ||||
| DHI | 0.13 | 0.09 | 0.58 | |||||||||||||||
| Cl | 0.72 | 0.81 | 0.86 | |||||||||||||||
| Jimenez | P/E | Left CW | Metric (%Rx | P/E | WT | IP | Metric (%Rx | P/E | WT | IP | Metric ( c/( Rx | P/E | WT | IP | ||||
| (31) | WT | (n=5) | Dose) | Dose) | Dose) | |||||||||||||
| IP | Right CW | Mean to PTV | 99 | 100 | 100 | LV5 | 26.6 | 19.7 | 2.8 | LV5 | 53.6 | 49.2 | 14.9 | |||||
| (n=5) | Max | 133 | 120 | 115 | L V10 | 15.8 | 16.2 | 1.0 | L V10 | 43.6 | 42.2 | 9.5 | ||||||
| D2 | 124 | 116 | 114 | L V20 R V5 R V10 RV20 | 7.8 11.5 4.6 1.2 |
13.6 1.2 0.5 0.3 |
0.4 0.3 0.1 0.1 |
LV20 RV5 RV10 RV20 |
31.9 65.1 52 36.4 |
36.7 44.6 38.3 |
4.3 13.5 8.6 4.1 |
|||||||
| MacDonald | P/E | Left CW (n=l 1 ) | Metric (%Rx | P/E | WT | PP | Metric | P/E | WT | |||||||||
| (32) | WT PP |
Dose) | (%Rx Dose) |
|||||||||||||||
| PP | Metric (%Rx | P/E | WT | PP | ||||||||||||||
| Dose) | ||||||||||||||||||
| V90 92 | 94 | 99 | V5 | 35.6 | 20.9 | |||||||||||||
| 4.1 | L V5 | 46.3 | 33.2 | 25.2 | V95 | 89 | 91 | 98 | ||||||||||
| VI0 22.7 | 14.9 | 2.8 | L VI0 | 32.2 28.5 | 21.3 | |||||||||||||
| V20 | 12.4 | 12 | 1.6 | LV20 | 21.7 | 25.3 | 16.2 | |||||||||||
| V45 2.2 | 6.9 | 0.3 | ||||||||||||||||
| Ranger | WT-DIBH | Left | Metric (%Rx | WT | VM | IP | Metric (Gy) | WT | VM | IP | Metric ( Gy) | WT | VM | IP | Metric | WT | VM | IP |
| (24) | VMAT-DIBH | WB | I)ose) | (Gy) | ||||||||||||||
| IMPT-FB | (n=10) CW (n=4) |
PTV | 85 | 96 | 100 | Mean V17Gy (%) L AD Max |
2.5 2 38.3 |
2.6 1.8 36.2 |
1.0 1.3 17.4 |
V17Gy (%) Mean | 28 0.8 |
28 0.7 |
17 0.2 |
Mean | 1.4 | 1.5 | 0.2 | |
| Flejmer | 3D-DIBH | Left WB | Metric | 3D | UP | IP | Metric | 3D | UP | IP | Metric | 3D | UP | IP | ||||
| (29) | UP-DIBH | or CW | PTV Mean (Gy) | 50.1 | 50.« | 50.0 | Mean (Gy) | 2.1 | 0.2 | 0.2 | L Mean (Gy) | 12.3 | 7.3 | 6.9 | ||||
| IP-DIBH | (n=10) | PTV V95 (%) | 93.9 | 97.1 | 99.0 | D2% (Gy) | 16.7 | 3.2 | 3.2 | LD2% | 46.9 | 32.9 | 33.6 | |||||
| PTV V105 (%) | 5.0 | 0.1 | 0.1 | V20 ( % ) | 1.6 | 0 | 0.1 | L V20(%) | 23.3 | 13.1 | 11.3 | |||||||
| PTV D98 ( % ) | 46.7 | 47.0 | 48.2 | V5 (%) | 4.9 | 1.3 | 1.3 | L V10(%) | 30.1 | 28.8 | 26.8 | |||||||
| PTV 1)2% (Gy) | 52.8 | 51.4 | 51.2 | LAD Mean (Gy) |
14.6 | 3.2 | 3.3 | Integral Dose (Gy) | 114.1 | 67.0 | 67.0 | |||||||
| HI | 12.3 | 8.8 | 6.0 | LAD D2% (Gy) |
29.9 | 10.2 | 10.3 | |||||||||||
| Fagundes | 3D | Left CW | Metric | 3D | VM | IP | Metric | 3D | VM | IP | Metric | 3D | VM | IP | Metric 3D VM | IP | ||
| (30) | VM | (n=10) | PTV V100(%) | 69.2 | 85.8 | 81.9 | Mean (Gy) | 6.8 | 8.2 | 1.2 | L V20 (%) | 40.4 | 27.3 | 28.4 | V5 (%) 0.5 19.7 | 3.8 | ||
| IP | PTV V95 (%) | 86.5 | 95.6 | 91.6 | V25 (%)’ | 6.3 | 7.4 | 1.2 | L V10 (%) | 53.3 | 40.6 | 35.9 | Mean 0.5 3.8 (Gy) | 0.6 | ||||
| PTV V90(%) | 92.2 | 98.4 | 95.8 | LAD Mean (Gy) |
20.9 | 15.5 | 7.0 | L V5 (%) | 66.4 | 58 | 41.3 | |||||||
Abbreviations: VM = volumctric nnxiulatcd arc therapy: PP = passively scattered proton therapy: WT = 3D conformai wide tangents: IM = intensity modulated radiation therapy: IP = intensity modulated proton therapy: UP = single field uniform proton therapy: WB = whole breast; CW = chest wall, 3D-CRT = 3D conformai radiotherapy: DH1 = dose homogeneity index: Cl = conformity index; DIBH = deep inspiratory breast hold: Gy = Gray (Relative Biological Effectiveness [RBE]); LAD = left anterior descending artery.
When a range was given, the average value is shown.
Bolded and italicized values have an associated p-value less than 0.05, indicating a statistically significant difference versus the comparative group, when these data were available.