Yiling Zeng, Qi Zhang, Bo Pang, Muyu Liu, Yu Chang, Ye Wang, Hong Quan, Zhiyong Yang
{"title":"实施透射质子 FLASH-RT 的分馏剂量优化设施。","authors":"Yiling Zeng, Qi Zhang, Bo Pang, Muyu Liu, Yu Chang, Ye Wang, Hong Quan, Zhiyong Yang","doi":"10.1088/1361-6560/ad75e3","DOIUrl":null,"url":null,"abstract":"<p><p><i>Objective.</i>The beam switching time and fractional dose influence the FLASH effect. A single-beam-per-fraction (SBPF) scheme using uniform fractional dose (UFD) has been proposed for FLASH- radiotherapy (FLASH-RT) to eliminate the beam switching time. Based on SBPF schemes, a fractionation dose optimization algorithm is proposed to optimize non-UFD plans to maximize the fractionation effect and dose-dependent FLASH effect.<i>Approach.</i>The UFD plan, containing five 236 MeV transmission proton beams, was optimized for 11 patients with peripheral lung cancer, with each beam delivering a uniform dose of 11 Gy to the target. Meanwhile, the non-UFD plan was optimized using fractionation dose optimization. To compare the two plans, the equivalent dose to 2 Gy (EQD2) for the target and normal tissues was calculated with an<i>α</i>/<i>β</i>ratio of 10 and 3, respectively. Both UFD and non-UFD plans ensured that the target received an EQD2 of 96.3 Gy. To investigate the overall improvement in normal tissue sparing with the non-UFD plan, the FLASH-enhanced EQD2 was calculated.<i>Main results.</i>The fractional doses in non-UFD plans ranged between 5.0 Gy and 24.2 Gy. No significant differences were found in EQD2<sub>2%</sub>and EQD2<sub>98%</sub>of targets between UFD and non-UFD plans. However, the<i>D</i><sub>95%</sub>of the target in non-UFD plans was significantly reduced by 15.1%. The sparing effect in non-UFD plans was significantly improved. The FLASH-enhanced EQD2<sub>mean</sub>in normal tissue and ipsilateral lung was significantly reduced by 3.5% and 10.4%, respectively, in non-UFD plans. The overall improvement is attributed to both the FLASH and fractionation effects.<i>Significance.</i>The fractionation dose optimization can address the limitation of multiple-beam FLASH-RT and utilize the relationship between fractional dose and FLASH effect. Consequently, the non-UFD scheme results in further improvements in normal tissue sparing compared to the UFD scheme, attributed to enhanced fractionation and FLASH effects.</p>","PeriodicalId":20185,"journal":{"name":"Physics in medicine and biology","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fractionation dose optimization facilities the implementation of transmission proton FLASH-RT.\",\"authors\":\"Yiling Zeng, Qi Zhang, Bo Pang, Muyu Liu, Yu Chang, Ye Wang, Hong Quan, Zhiyong Yang\",\"doi\":\"10.1088/1361-6560/ad75e3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><i>Objective.</i>The beam switching time and fractional dose influence the FLASH effect. A single-beam-per-fraction (SBPF) scheme using uniform fractional dose (UFD) has been proposed for FLASH- radiotherapy (FLASH-RT) to eliminate the beam switching time. Based on SBPF schemes, a fractionation dose optimization algorithm is proposed to optimize non-UFD plans to maximize the fractionation effect and dose-dependent FLASH effect.<i>Approach.</i>The UFD plan, containing five 236 MeV transmission proton beams, was optimized for 11 patients with peripheral lung cancer, with each beam delivering a uniform dose of 11 Gy to the target. Meanwhile, the non-UFD plan was optimized using fractionation dose optimization. To compare the two plans, the equivalent dose to 2 Gy (EQD2) for the target and normal tissues was calculated with an<i>α</i>/<i>β</i>ratio of 10 and 3, respectively. Both UFD and non-UFD plans ensured that the target received an EQD2 of 96.3 Gy. To investigate the overall improvement in normal tissue sparing with the non-UFD plan, the FLASH-enhanced EQD2 was calculated.<i>Main results.</i>The fractional doses in non-UFD plans ranged between 5.0 Gy and 24.2 Gy. No significant differences were found in EQD2<sub>2%</sub>and EQD2<sub>98%</sub>of targets between UFD and non-UFD plans. However, the<i>D</i><sub>95%</sub>of the target in non-UFD plans was significantly reduced by 15.1%. The sparing effect in non-UFD plans was significantly improved. The FLASH-enhanced EQD2<sub>mean</sub>in normal tissue and ipsilateral lung was significantly reduced by 3.5% and 10.4%, respectively, in non-UFD plans. The overall improvement is attributed to both the FLASH and fractionation effects.<i>Significance.</i>The fractionation dose optimization can address the limitation of multiple-beam FLASH-RT and utilize the relationship between fractional dose and FLASH effect. Consequently, the non-UFD scheme results in further improvements in normal tissue sparing compared to the UFD scheme, attributed to enhanced fractionation and FLASH effects.</p>\",\"PeriodicalId\":20185,\"journal\":{\"name\":\"Physics in medicine and biology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physics in medicine and biology\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1088/1361-6560/ad75e3\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physics in medicine and biology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1088/1361-6560/ad75e3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
Fractionation dose optimization facilities the implementation of transmission proton FLASH-RT.
Objective.The beam switching time and fractional dose influence the FLASH effect. A single-beam-per-fraction (SBPF) scheme using uniform fractional dose (UFD) has been proposed for FLASH- radiotherapy (FLASH-RT) to eliminate the beam switching time. Based on SBPF schemes, a fractionation dose optimization algorithm is proposed to optimize non-UFD plans to maximize the fractionation effect and dose-dependent FLASH effect.Approach.The UFD plan, containing five 236 MeV transmission proton beams, was optimized for 11 patients with peripheral lung cancer, with each beam delivering a uniform dose of 11 Gy to the target. Meanwhile, the non-UFD plan was optimized using fractionation dose optimization. To compare the two plans, the equivalent dose to 2 Gy (EQD2) for the target and normal tissues was calculated with anα/βratio of 10 and 3, respectively. Both UFD and non-UFD plans ensured that the target received an EQD2 of 96.3 Gy. To investigate the overall improvement in normal tissue sparing with the non-UFD plan, the FLASH-enhanced EQD2 was calculated.Main results.The fractional doses in non-UFD plans ranged between 5.0 Gy and 24.2 Gy. No significant differences were found in EQD22%and EQD298%of targets between UFD and non-UFD plans. However, theD95%of the target in non-UFD plans was significantly reduced by 15.1%. The sparing effect in non-UFD plans was significantly improved. The FLASH-enhanced EQD2meanin normal tissue and ipsilateral lung was significantly reduced by 3.5% and 10.4%, respectively, in non-UFD plans. The overall improvement is attributed to both the FLASH and fractionation effects.Significance.The fractionation dose optimization can address the limitation of multiple-beam FLASH-RT and utilize the relationship between fractional dose and FLASH effect. Consequently, the non-UFD scheme results in further improvements in normal tissue sparing compared to the UFD scheme, attributed to enhanced fractionation and FLASH effects.
期刊介绍：
The development and application of theoretical, computational and experimental physics to medicine, physiology and biology. Topics covered are: therapy physics (including ionizing and non-ionizing radiation); biomedical imaging (e.g. x-ray, magnetic resonance, ultrasound, optical and nuclear imaging); image-guided interventions; image reconstruction and analysis (including kinetic modelling); artificial intelligence in biomedical physics and analysis; nanoparticles in imaging and therapy; radiobiology; radiation protection and patient dose monitoring; radiation dosimetry
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