Wenguang Chen, Feng Yang, Fanrui Zeng, Hao Guo, Yuankang Xu, Tianyu Zhang, Junxiang Wu, Da Zhang, Gang Liu, Xuanfeng Ding, Xianliang Wang
{"title":"解剖改变对肺癌模拟质子弧治疗和调强质子治疗的影响","authors":"Wenguang Chen, Feng Yang, Fanrui Zeng, Hao Guo, Yuankang Xu, Tianyu Zhang, Junxiang Wu, Da Zhang, Gang Liu, Xuanfeng Ding, Xianliang Wang","doi":"10.1002/acm2.70881","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>: During lung cancer radiotherapy, inter-fractional anatomical changes may cause the delivered dose to deviate from the primary plan, affecting tumor control and increasing the risk of normal tissue damage. This study aims to evaluate the impact of anatomical changes on the dosimetric and radiobiological performance of simulated proton arc therapy (sPAT) versus intensity-modulated proton therapy (IMPT) for lung cancer patients under patient-specific anatomical changes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>: Data from 21 lung cancer patients were retrospectively analyzed. The prescribed dose for all patients was 6000 cGy (relative biological effectiveness, RBE). Each patient with a primary planning computed tomography (pCT) and a mid-treatment adaptive-planning CT (aCT) acquired at a median of 29 days into treatment due to notable tumor volume changes. Primary plans for sPAT and IMPT were designed on the pCT. After rigid registration of the pCT and aCT, non-adaptive plans (sPAT<sub>p-a</sub>, IMPT<sub>p-a</sub>) were generated by directly recalculating the doses of the primary plans on the aCT. The comparison evaluated the dosimetric impact of anatomical changes by comparing non-adaptive plans (sPAT<sub>p-a</sub> vs. IMPT<sub>p-a</sub>). Dose-volume histogram (DVH) parameters for targets and organs at risk (OARs) and tumor control probability (TCP) and normal tissue complication probability (NTCP) were evaluated.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>: For the primary plans, sPAT and IMPT achieved similar target coverage, while the doses to OARs were generally lower in sPAT<sub>p</sub>. Under anatomical changes, both non-adaptive plans exhibited a decrease in target coverage, sPAT<sub>p-a</sub> achieved a D<sub>95%</sub> of 5567.57 cGy[RBE] compared with 5423.33 cGy[RBE] for IMPT<sub>p-a</sub> (<i>p</i> < 0.001), indicating that sPAT better preserved target coverage. Compared with the primary plans, sPAT<sub>p-a</sub> and IMPT<sub>p-a</sub> exhibited TCP reductions of 5.83% and 8.07%, respectively.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>: Compared with IMPT, sPAT exhibits enhanced robustness against inter-fractional anatomical changes occurring in lung-cancer radiotherapy.</p>\n </section>\n </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 11","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70881","citationCount":"0","resultStr":"{\"title\":\"Impact of anatomical changes on simulated proton arc therapy and intensity-modulated proton therapy for lung cancer\",\"authors\":\"Wenguang Chen, Feng Yang, Fanrui Zeng, Hao Guo, Yuankang Xu, Tianyu Zhang, Junxiang Wu, Da Zhang, Gang Liu, Xuanfeng Ding, Xianliang Wang\",\"doi\":\"10.1002/acm2.70881\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>: During lung cancer radiotherapy, inter-fractional anatomical changes may cause the delivered dose to deviate from the primary plan, affecting tumor control and increasing the risk of normal tissue damage. This study aims to evaluate the impact of anatomical changes on the dosimetric and radiobiological performance of simulated proton arc therapy (sPAT) versus intensity-modulated proton therapy (IMPT) for lung cancer patients under patient-specific anatomical changes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>: Data from 21 lung cancer patients were retrospectively analyzed. The prescribed dose for all patients was 6000 cGy (relative biological effectiveness, RBE). Each patient with a primary planning computed tomography (pCT) and a mid-treatment adaptive-planning CT (aCT) acquired at a median of 29 days into treatment due to notable tumor volume changes. Primary plans for sPAT and IMPT were designed on the pCT. After rigid registration of the pCT and aCT, non-adaptive plans (sPAT<sub>p-a</sub>, IMPT<sub>p-a</sub>) were generated by directly recalculating the doses of the primary plans on the aCT. 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Impact of anatomical changes on simulated proton arc therapy and intensity-modulated proton therapy for lung cancer
Purpose
: During lung cancer radiotherapy, inter-fractional anatomical changes may cause the delivered dose to deviate from the primary plan, affecting tumor control and increasing the risk of normal tissue damage. This study aims to evaluate the impact of anatomical changes on the dosimetric and radiobiological performance of simulated proton arc therapy (sPAT) versus intensity-modulated proton therapy (IMPT) for lung cancer patients under patient-specific anatomical changes.
Methods
: Data from 21 lung cancer patients were retrospectively analyzed. The prescribed dose for all patients was 6000 cGy (relative biological effectiveness, RBE). Each patient with a primary planning computed tomography (pCT) and a mid-treatment adaptive-planning CT (aCT) acquired at a median of 29 days into treatment due to notable tumor volume changes. Primary plans for sPAT and IMPT were designed on the pCT. After rigid registration of the pCT and aCT, non-adaptive plans (sPATp-a, IMPTp-a) were generated by directly recalculating the doses of the primary plans on the aCT. The comparison evaluated the dosimetric impact of anatomical changes by comparing non-adaptive plans (sPATp-a vs. IMPTp-a). Dose-volume histogram (DVH) parameters for targets and organs at risk (OARs) and tumor control probability (TCP) and normal tissue complication probability (NTCP) were evaluated.
Results
: For the primary plans, sPAT and IMPT achieved similar target coverage, while the doses to OARs were generally lower in sPATp. Under anatomical changes, both non-adaptive plans exhibited a decrease in target coverage, sPATp-a achieved a D95% of 5567.57 cGy[RBE] compared with 5423.33 cGy[RBE] for IMPTp-a (p < 0.001), indicating that sPAT better preserved target coverage. Compared with the primary plans, sPATp-a and IMPTp-a exhibited TCP reductions of 5.83% and 8.07%, respectively.
Conclusions
: Compared with IMPT, sPAT exhibits enhanced robustness against inter-fractional anatomical changes occurring in lung-cancer radiotherapy.
期刊介绍：
Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission.
JACMP will publish:
-Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500.
-Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed.
-Technical Notes: These should be no longer than 3000 words, including key references.
-Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents.
-Book Reviews: The editorial office solicits Book Reviews.
-Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics.
-Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic
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