Investigation of interfractional range variation owing to anatomical changes with beam directions based on water equivalent thickness in proton therapy for pancreatic cancer.

IF 1.9 4区 医学 Q2 BIOLOGY
Yuhei Kikkawa, Hideaki Ueda, Yusuke Uchinami, Norio Katoh, Hidefumi Aoyama, Yoichi M Ito, Kohei Yokokawa, Ye Chen, Taeko Matsuura, Naoki Miyamoto, Seishin Takao
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Abstract

To assess the interfractional anatomical range variations (ARVs) with beam directions and their impact on dose distribution in intensity modulated proton therapy, we analyzed water equivalent thickness (WET) from 10 patients with pancreatic cancer. The distributions of the interfractional WET difference ($\Delta{\mathrm{WET}}^{\theta }$) across 360° were visualized using polar histograms. Interfractional ARVs were evaluated using the mean absolute error and ΔWET pass rate, indicating the percentage of $\Delta \mathrm{WE}{\mathrm{T}}^{\theta }$ < thresholds. The impact on dose distribution in proton therapy was evaluated based on two treatment plans for 40 Gy(RBE)/5 fractions: 'Plan A', using two beam angles, in which the target was closest to the body surface among four perpendicular directions; and 'Plan B', using two beam angles with small ARVs. Analysis revealed individual variations in angular trends of interfractional ARVs. Three distinct trends were identified: Group 1 exhibited small ARVs around posterior directions; Group 2 exhibited small ARVs except ~60°; Group 3 demonstrated minimal ARVs only ~90°. In dose evaluation, while 150° and 210° were selected in Plan B for 9 out of 10 patients, for the remaining patient, 60° and 90° were chosen. Comparing dose volume histogram parameters for all patients, Plan B significantly reduced target coverage loss while maintaining organ-at-risk sparing comparable to Plan A. These results demonstrated that selecting beam angles with small interfractional ARVs for each patient enhances the robustness of dose distribution, reducing target coverage loss.

根据质子治疗胰腺癌时的水等效厚度,研究解剖学变化导致的射束方向点间范围变化。
为了评估强度调制质子治疗中射束方向的切面解剖范围变化(ARV)及其对剂量分布的影响,我们分析了10名胰腺癌患者的水等效厚度(WET)。我们使用极直方图直观地显示了360°范围内切分间WET差值($\Delta{\mathrm{WET}}^{\theta }$)的分布情况。使用平均绝对误差和 ΔWET 通过率评估了分数间 ARV,表明 $\Delta \mathrm{WE}{mathrm{T}}^{\theta }$ < 临界值的百分比。质子治疗中剂量分布的影响是根据两种治疗方案(40 Gy(RBE)/5 分数)进行评估的:A计划 "采用两个射束角,在四个垂直方向中,靶点最靠近体表;"B计划 "采用两个射束角,ARV较小。分析显示,点阵间 ARV 的角度趋势存在个体差异。确定了三种不同的趋势:第 1 组在后方方向表现出较小的 ARV;第 2 组除 ~60° 外表现出较小的 ARV;第 3 组仅在 ~90° 表现出最小的 ARV。在剂量评估中,10 位患者中有 9 位在 B 计划中选择了 150°和 210°,其余患者则选择了 60°和 90°。比较所有患者的剂量体积直方图参数,B 方案显著减少了目标覆盖损失,同时保持了与 A 方案相当的风险器官疏通。
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
CiteScore
3.60
自引率
5.00%
发文量
86
审稿时长
4-8 weeks
期刊介绍: The Journal of Radiation Research (JRR) is an official journal of The Japanese Radiation Research Society (JRRS), and the Japanese Society for Radiation Oncology (JASTRO). Since its launch in 1960 as the official journal of the JRRS, the journal has published scientific articles in radiation science in biology, chemistry, physics, epidemiology, and environmental sciences. JRR broadened its scope to include oncology in 2009, when JASTRO partnered with the JRRS to publish the journal. Articles considered fall into two broad categories: Oncology & Medicine - including all aspects of research with patients that impacts on the treatment of cancer using radiation. Papers which cover related radiation therapies, radiation dosimetry, and those describing the basis for treatment methods including techniques, are also welcomed. Clinical case reports are not acceptable. Radiation Research - basic science studies of radiation effects on livings in the area of physics, chemistry, biology, epidemiology and environmental sciences. Please be advised that JRR does not accept any papers of pure physics or chemistry. The journal is bimonthly, and is edited and published by the JRR Editorial Committee.
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