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Jalaj S, Lee SY, McGaw C, et al. Proton radiotherapy dose perturbations caused by esophageal stents of varying material composition are negligible in an experimental model. Endosc Int Open. 2014;3(1):E46-50doi: 10.1055/s-0034-1390709.
Jalaj, S., Lee, S. Y., McGaw, C., John, B. K., Li, Z., Awad, Z. T., Scolapio, J. S., & Munoz, J. C. (2015). Proton radiotherapy dose perturbations caused by esophageal stents of varying material composition are negligible in an experimental model. Endoscopy international open, 3(1), E46-50. https://doi.org/10.1055/s-0034-1390709
Jalaj, Sujai, et al. "Proton radiotherapy dose perturbations caused by esophageal stents of varying material composition are negligible in an experimental model." Endoscopy international open vol. 3,1 (2015): E46-50. doi: https://doi.org/10.1055/s-0034-1390709
Jalaj S, Lee SY, McGaw C, John BK, Li Z, Awad ZT, Scolapio JS, Munoz JC. Proton radiotherapy dose perturbations caused by esophageal stents of varying material composition are negligible in an experimental model. Endosc Int Open. 2015 Feb;3(1):E46-50. doi: 10.1055/s-0034-1390709. Epub 2014 Oct 24. PMID: 26134771; PMCID: PMC4423262.
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Endosc Int Open. 2015 Feb;3(1):E46-50. doi: 10.1055/s-0034-1390709. Epub 2014 Oct 24.

Proton radiotherapy dose perturbations caused by esophageal stents of varying material composition are negligible in an experimental model.

Endoscopy international open

Sujai Jalaj, Sang Yeob Lee, Camille McGaw, Bijo K John, Zuofeng Li, Ziad T Awad, James S Scolapio, Juan C Munoz

Affiliations

  1. Division of Gastroenterology, Department of Medicine, University of Florida, Jacksonville College of Medicine, Jacksonville, Florida, United States.
  2. Department of Radiation Oncology, University of Florida, Proton Therapy Institute, Jacksonville, Florida, United States.
  3. Department of Surgery, University of Florida, Jacksonville College of Medicine, Jacksonville, Florida, United States.

PMID: 26134771 PMCID: PMC4423262 DOI: 10.1055/s-0034-1390709

Abstract

BACKGROUND: Self-expanding metal and plastic esophageal stents (SEMS and SEPS, respectively) are used in conjunction with chemoradiation for palliation of malignant dysphagia. To date, the dosimetric effects of stents undergoing proton radiotherapy are not known.

STUDY AIM: To investigate the proton radiotherapy dose perturbations caused by esophageal stents of varying designs and materials undergoing external beam treatment for esophageal cancer.

PATIENTS AND METHODS: Simulated clinical protocol. Solid acrylic phantom was used to mimic the esophageal tissue environment. Stents made of nitinol, stainless steel and polyester were tested. Proton beam dose of 2 Gy-E was delivered to each stent in a single anterior to posterior field. Film and image based evidence of dose perturbation were main outcomes measured.

RESULTS: Only the stainless steel and plastic stents demonstrated slight overall dose attenuations (- 0.5 % and - 0.4 %, respectively). All the nitinol-based stents demonstrated minimal overall dose perturbations ranging from 0.0 % to 1.2 %. Negligible dose perturbations were observed on each of the stent surfaces proximal to the radiation source, ranging from - 0.8 % (stainless steel stent) to 1.0 % (nitinol stent). Negligible dose effects were also observed on the distal surfaces of each stent ranging from - 0.5 % (plastic and stainless steel stents) to 1.0 % (nitinol stent).

CONCLUSION: Proton radiotherapy dose perturbations caused by stents of varying designs and material composition are negligible. Negligible dose perturbation is in keeping with the inherent advantage of proton therapy over traditional radiotherapy composed of photons - given its relative large mass, protons have little side scatter.

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