Aditya Halthore, Zachary Fellows, Anh Tran, Curtiland Deville, Jean L Wright, Jeffrey Meyer, Heng Li, Khadija Sheikh
{"title":"铅笔束扫描质子网格治疗大体积肿瘤的治疗计划。","authors":"Aditya Halthore, Zachary Fellows, Anh Tran, Curtiland Deville, Jean L Wright, Jeffrey Meyer, Heng Li, Khadija Sheikh","doi":"10.14338/IJPT-22-00028","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare spatially fractionated radiation therapy (GRID) treatment planning techniques using proton pencil-beam-scanning (PBS) and photon therapy.</p><p><strong>Materials and methods: </strong>PBS and volumetric modulated arc therapy (VMAT) GRID plans were retrospectively generated for 5 patients with bulky tumors. GRID targets were arranged along the long axis of the gross tumor, spaced 2 and 3 cm apart, and treated with a prescription of 18 Gy. PBS plans used 2- to 3-beam multiple-field optimization with robustness evaluation. Dosimetric parameters including peak-to-edge ratio (PEDR), ratio of dose to 90% of the valley to dose to 10% of the peak VPDR(D90/D10), and volume of normal tissue receiving at least 5 Gy (V5) and 10 Gy (V10) were calculated. The peak-to-valley dose ratio (PVDR), VPDR(D90/D10), and organ-at-risk doses were prospectively assessed in 2 patients undergoing PBS-GRID with pretreatment quality assurance computed tomography (QACT) scans.</p><p><strong>Results: </strong>PBS and VMAT GRID plans were generated for 5 patients with bulky tumors. Gross tumor volume values ranged from 826 to 1468 cm<sup>3</sup>. Peak-to-edge ratio for PBS was higher than for VMAT for both spacing scenarios (2-cm spacing, <i>P</i> = .02; 3-cm spacing, <i>P</i> = .01). VPDR(D90/D10) for PBS was higher than for VMAT (2-cm spacing, <i>P</i> = .004; 3-cm spacing, <i>P</i> = .002). Normal tissue V5 was lower for PBS than for VMAT (2-cm spacing, <i>P</i> = .03; 3-cm spacing, <i>P</i> = .02). Normal tissue mean dose was lower with PBS than with VMAT (2-cm spacing, <i>P =</i> .03; 3-cm spacing, <i>P =</i> .02). Two patients treated using PBS GRID and assessed with pretreatment QACT scans demonstrated robust PVDR, VPDR(D90/D10), and organs-at-risk doses.</p><p><strong>Conclusions: </strong>The PEDR was significantly higher for PBS than VMAT plans, indicating lower target edge dose. Normal tissue mean dose was significantly lower with PBS than VMAT. PBS GRID may result in lower normal tissue dose compared with VMAT plans, allowing for further dose escalation in patients with bulky disease.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"9 3","pages":"40-49"},"PeriodicalIF":2.1000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875826/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy.\",\"authors\":\"Aditya Halthore, Zachary Fellows, Anh Tran, Curtiland Deville, Jean L Wright, Jeffrey Meyer, Heng Li, Khadija Sheikh\",\"doi\":\"10.14338/IJPT-22-00028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare spatially fractionated radiation therapy (GRID) treatment planning techniques using proton pencil-beam-scanning (PBS) and photon therapy.</p><p><strong>Materials and methods: </strong>PBS and volumetric modulated arc therapy (VMAT) GRID plans were retrospectively generated for 5 patients with bulky tumors. GRID targets were arranged along the long axis of the gross tumor, spaced 2 and 3 cm apart, and treated with a prescription of 18 Gy. PBS plans used 2- to 3-beam multiple-field optimization with robustness evaluation. Dosimetric parameters including peak-to-edge ratio (PEDR), ratio of dose to 90% of the valley to dose to 10% of the peak VPDR(D90/D10), and volume of normal tissue receiving at least 5 Gy (V5) and 10 Gy (V10) were calculated. The peak-to-valley dose ratio (PVDR), VPDR(D90/D10), and organ-at-risk doses were prospectively assessed in 2 patients undergoing PBS-GRID with pretreatment quality assurance computed tomography (QACT) scans.</p><p><strong>Results: </strong>PBS and VMAT GRID plans were generated for 5 patients with bulky tumors. Gross tumor volume values ranged from 826 to 1468 cm<sup>3</sup>. Peak-to-edge ratio for PBS was higher than for VMAT for both spacing scenarios (2-cm spacing, <i>P</i> = .02; 3-cm spacing, <i>P</i> = .01). VPDR(D90/D10) for PBS was higher than for VMAT (2-cm spacing, <i>P</i> = .004; 3-cm spacing, <i>P</i> = .002). Normal tissue V5 was lower for PBS than for VMAT (2-cm spacing, <i>P</i> = .03; 3-cm spacing, <i>P</i> = .02). Normal tissue mean dose was lower with PBS than with VMAT (2-cm spacing, <i>P =</i> .03; 3-cm spacing, <i>P =</i> .02). Two patients treated using PBS GRID and assessed with pretreatment QACT scans demonstrated robust PVDR, VPDR(D90/D10), and organs-at-risk doses.</p><p><strong>Conclusions: </strong>The PEDR was significantly higher for PBS than VMAT plans, indicating lower target edge dose. Normal tissue mean dose was significantly lower with PBS than VMAT. 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引用次数: 0
摘要
目的:比较质子铅笔束扫描(PBS)和光子治疗的空间分割放射治疗(GRID)治疗计划技术。材料和方法:回顾性生成5例体积较大肿瘤的PBS和体积调制电弧治疗(VMAT) GRID方案。GRID靶沿大体肿瘤的长轴排列，间隔2和3cm，并以18 Gy的处方治疗。PBS计划采用2至3束多场优化和鲁棒性评估。计算剂量学参数，包括峰边比(PEDR)、谷值90%的剂量与峰值VPDR 10%的剂量之比(D90/D10)、正常组织接受至少5 Gy (V5)和10 Gy (V10)的体积。前瞻性评估了2例接受PBS-GRID预处理质量保证计算机断层扫描(QACT)的患者的峰谷剂量比(PVDR)、VPDR(D90/D10)和器官危险剂量。结果:生成了5例体积较大肿瘤的PBS和VMAT网格计划。大体肿瘤体积值为826 ~ 1468 cm3。在两种间距情况下，PBS的峰边比均高于VMAT(间距为2 cm, P = 0.02;间距3 cm, P = 0.01)。PBS的VPDR(D90/D10)高于VMAT (2 cm间距，P = 0.004;间距3厘米，P = 0.002)。PBS组正常组织V5低于VMAT组(间隔2 cm, P = .03;间距3 cm, P = 0.02)。PBS组正常组织平均剂量低于VMAT组(间隔2 cm, P = .03;间距3 cm, P = 0.02)。两名患者使用PBS GRID治疗并通过预处理QACT扫描评估，显示出强大的PVDR, VPDR(D90/D10)和器官危险剂量。结论:PBS组PEDR明显高于VMAT组，表明靶边缘剂量较低。PBS的正常组织平均剂量明显低于VMAT。与VMAT计划相比，PBS GRID可能导致较低的正常组织剂量，从而允许对体积较大的疾病患者进一步增加剂量。
Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy.
Purpose: To compare spatially fractionated radiation therapy (GRID) treatment planning techniques using proton pencil-beam-scanning (PBS) and photon therapy.
Materials and methods: PBS and volumetric modulated arc therapy (VMAT) GRID plans were retrospectively generated for 5 patients with bulky tumors. GRID targets were arranged along the long axis of the gross tumor, spaced 2 and 3 cm apart, and treated with a prescription of 18 Gy. PBS plans used 2- to 3-beam multiple-field optimization with robustness evaluation. Dosimetric parameters including peak-to-edge ratio (PEDR), ratio of dose to 90% of the valley to dose to 10% of the peak VPDR(D90/D10), and volume of normal tissue receiving at least 5 Gy (V5) and 10 Gy (V10) were calculated. The peak-to-valley dose ratio (PVDR), VPDR(D90/D10), and organ-at-risk doses were prospectively assessed in 2 patients undergoing PBS-GRID with pretreatment quality assurance computed tomography (QACT) scans.
Results: PBS and VMAT GRID plans were generated for 5 patients with bulky tumors. Gross tumor volume values ranged from 826 to 1468 cm3. Peak-to-edge ratio for PBS was higher than for VMAT for both spacing scenarios (2-cm spacing, P = .02; 3-cm spacing, P = .01). VPDR(D90/D10) for PBS was higher than for VMAT (2-cm spacing, P = .004; 3-cm spacing, P = .002). Normal tissue V5 was lower for PBS than for VMAT (2-cm spacing, P = .03; 3-cm spacing, P = .02). Normal tissue mean dose was lower with PBS than with VMAT (2-cm spacing, P = .03; 3-cm spacing, P = .02). Two patients treated using PBS GRID and assessed with pretreatment QACT scans demonstrated robust PVDR, VPDR(D90/D10), and organs-at-risk doses.
Conclusions: The PEDR was significantly higher for PBS than VMAT plans, indicating lower target edge dose. Normal tissue mean dose was significantly lower with PBS than VMAT. PBS GRID may result in lower normal tissue dose compared with VMAT plans, allowing for further dose escalation in patients with bulky disease.
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