Comparing different boost concepts and beam configurations for proton therapy of pancreatic cancer

IF 3.4 Q2 ONCOLOGY
Taiki Takaoka , Takeshi Yanagi , Shinsei Takahashi , Yuta Shibamoto , Yuto Imai , Dai Okazaki , Masanari Niwa , Akira Torii , Nozomi Kita , Seiya Takano , Natsuo Tomita , Akio Hiwatashi
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Abstract

Background and Purpose

Interfractional geometrical and anatomical variations impact the accuracy of proton therapy for pancreatic cancer. This study investigated field-in-field (FIF) and simultaneous integrated boost (SIB) concepts for scanned proton therapy treatment with different beam configurations.

Materials and Methods

Robustly optimized treatment plans for fifteen patients were generated using FIF and SIB techniques with two, three, and four beams. The prescribed dose in 20 fractions was 60 Gy(RBE) for the internal gross tumor volume (IGTV) and 46 Gy(RBE) for the internal clinical target volume. Verification computed tomography (vCT) scans was performed on treatment days 1, 7, and 16. Initial treatment plans were recalculated on the rigidly registered vCTs. V100% and D95% for targets and D2cm3 for the stomach and duodenum were evaluated. Robustness evaluations (range uncertainty of 3.5 %) were performed to evaluate the stomach and duodenum dose-volume parameters.

Results

For all techniques, IGTV V100% and D95% decreased significantly when recalculating the dose on vCTs (p < 0.001). The median IGTV V100% and D95% over all vCTs ranged from 74.2 % to 90.2 % and 58.8 Gy(RBE) to 59.4 Gy(RBE), respectively. The FIF with two and three beams, and SIB with two beams maintained the highest IGTV V100% and D95%. In robustness evaluations, the ΔD2cm3 of stomach was highest in two beams plans, while the ΔD2cm3 of duodenum was highest in four beams plans, for both concepts.

Conclusion

Target coverage decreased when recalculating on CTs at different time for both concepts. The FIF with three beams maintained the highest IGTV coverage while sparing normal organs the most.

比较用于胰腺癌质子治疗的不同助推概念和射束配置
背景和目的胰腺癌的几何和解剖结构变化会影响质子治疗的准确性。本研究探讨了场中场(FIF)和同步综合增强(SIB)概念,用于不同束流配置的质子治疗扫描。材料与方法使用FIF和SIB技术,用2束、3束和4束产生了15名患者的最佳治疗方案。20个分次的规定剂量为:肿瘤内部总体积(IGTV)60 Gy(RBE),肿瘤内部临床靶体积46 Gy(RBE)。在治疗第 1、7 和 16 天进行了验证计算机断层扫描(vCT)。根据刚性注册的 vCT 重新计算初始治疗计划。对目标的 V100% 和 D95% 以及胃和十二指肠的 D2cm3 进行了评估。对胃和十二指肠的剂量-容积参数进行了稳健性评估(范围不确定性为 3.5%)。结果对于所有技术,在 vCT 上重新计算剂量时,IGTV V100% 和 D95% 均显著下降(p <0.001)。所有 vCT 的中位 IGTV V100% 和 D95% 分别为 74.2% 至 90.2% 和 58.8 Gy(RBE) 至 59.4 Gy(RBE)。使用两束和三束的 FIF 以及使用两束的 SIB 保持了最高的 IGTV V100% 和 D95%。在稳健性评估中,对于两种概念,胃的ΔD2cm3 在两束计划中最高,而十二指肠的ΔD2cm3 在四束计划中最高。使用三波束的 FIF 保持了最高的 IGTV 覆盖率,同时最大程度地保护了正常器官。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Physics and Imaging in Radiation Oncology
Physics and Imaging in Radiation Oncology Physics and Astronomy-Radiation
CiteScore
5.30
自引率
18.90%
发文量
93
审稿时长
6 weeks
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