title: Treatment Planning Comparison for Carbon Ion Radiotherapy, Proton Therapy and Intensity-modulated Radiotherapy for Spinal Sarcoma.
abstract: OBJECTIVE
  Carbon ion radiotherapy (CIRT), proton therapy (PT) and intensity-modulated radiotherapy (IMRT) are new radiation modalities suitable for treatment of spinal sarcomas. The objective of the study was to compare the treatment planning of these modalities.
  
  
  METHODS
  We conducted a treatment planning comparison of the three modalities using a phantom imitating a spinal sarcoma and then six actual cases with spinal tumors. A uniform biological effective dose (BED) of 90 Gy10 was prescribed in previously reported fractionation schedules for each modality. The surface/center spinal cord dose constraints were set to BED of 96/77 Gy(E)3, respectively.
  
  
  RESULTS
  CIRT achieved better homogeneity of dose distribution and coverage of target than PT independently of tumor extent around the spinal cord. In IMRT plans, the spinal cord dose was higher than that under CIRT and PT and coverage of the target deteriorated depending on the tumor extension.
  
  
  CONCLUSIONS
  CIRT was most appropriate for the treatment of advanced spinal sarcomas.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan nakam@radiol.med.kyushu-u.ac.jp.
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Ion Beam Therapy Center, SAGA-HIMAT Foundation, Tosu, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shioyama
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tomonari
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Saiji
authors.initials: S
authors.lastname: Ohga
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tadamasa
authors.initials: T
authors.lastname: Yoshitake
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Asai
authors.affiliation: Ion Beam Therapy Center, SAGA-HIMAT Foundation, Tosu, Japan.
authors.forename: Genyu
authors.initials: G
authors.lastname: Kakiuchi
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D063193:Heavy Ion Radiotherapy / Q000379:methods; D006801:Humans; D061766:Proton Therapy / Q000379:methods; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012189:Retrospective Studies; D012509:Sarcoma / Q000532:radiotherapy*; D013125:Spinal Neoplasms / Q000532:radiotherapy*
keywords: Carbon ion radiotherapy; intensity-modulated radiotherapy; patch-field technique; proton therapy; spinal sarcoma