Feasibility of Utilizing Spot-Scanning Proton Arc (SPArc) for Whole-Lung Irradiation: A Case Report.

IF 2.1 Q3 ONCOLOGY

International Journal of Particle Therapy Pub Date : 2025-05-22 eCollection Date: 2025-06-01 DOI:10.1016/j.ijpt.2025.100750

Peilin Liu, Lewei Zhao, Gang Liu, Xi Cao, An Qin, Di Yan, Xiaoqiang Li, Craig Stevens, Rohan Deraniyagala, Xuanfeng Ding

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Abstract

Purpose: Photon radiotherapy is the conventional method in the treatment of bilateral whole-lung metastasis. However, uncertainties, longer delivery times, large lateral penumbra, and motion interplay limit intensity-modulated proton therapy (IMPT)'s use in bilateral lung metastases. To overcome such limitations in IMPT, this study explores the feasibility of using a novel proton therapy technique, Spot-scanning Proton Arc (SPArc) therapy, to improve the dose sparing to the heart and other healthy tissue for this pediatric patient compared to the volumetric modulated arc therapy (VMAT) and IMPT.

Patients and methods: A 13-year-old patient with a malignant neoplasm of bone and articular cartilage, presenting with bilateral whole-lung metastasis, received whole-lung irradiation of 15 Gy in 10 fractions using VMAT. For comparative analysis, plans were generated using IMPT and SPArc.

Results: The study showed that SPArc was superior in sparing the heart and enhancing delivery efficiency compared to both VMAT and IMPT. The mean heart dose was 5.41 Gy for SPArc, 8.48 Gy for IMPT, and 9.56 Gy for VMAT. D50 of the heart was 3.06 Gy for SPArc, 9.13 Gy for IMPT, and 9.12 Gy for VMAT. The integral body dose was 137 Gy·L in VMAT,189 Gy·L in IMPT, and 98 Gy·L in SPArc.

Conclusion: Spot-scanning proton arc demonstrated effective heart sparing and lower body-integral dose for whole-lung irradiation. Delivery simulations suggested improved efficiency compared with IMPT.

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利用点扫描质子弧（SPArc）进行全肺照射的可行性：1例报告。

目的：光子放射治疗是治疗双侧全肺转移的常规方法。然而，不确定性、较长的传递时间、较大的外侧半暗带和运动相互作用限制了强度调节质子治疗（IMPT）在双侧肺转移中的应用。为了克服IMPT的这些局限性，本研究探索了使用一种新型质子治疗技术的可行性，即点扫描质子弧（SPArc）治疗，与体积调节电弧治疗（VMAT）和IMPT相比，可以提高该儿科患者对心脏和其他健康组织的剂量节约。患者和方法：13岁的骨及关节软骨恶性肿瘤患者，双侧全肺转移，采用VMAT进行全肺10次15 Gy的放射治疗。为了进行比较分析，使用IMPT和SPArc生成计划。结果：研究表明，与VMAT和IMPT相比，SPArc在保护心脏和提高输送效率方面具有优势。SPArc的平均心脏剂量为5.41 Gy， IMPT为8.48 Gy， VMAT为9.56 Gy。SPArc组的心脏D50为3.06 Gy， IMPT组为9.13 Gy， VMAT组为9.12 Gy。VMAT组整体体剂量为137 Gy·L， IMPT组为189 Gy·L， SPArc组为98 Gy·L。结论：点扫描质子弧对全肺照射有较好的保心效果和较低的全身剂量。传递模拟表明，与IMPT相比，效率有所提高。

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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