The objective of this work is to compare the planning target volume (PTV)-based intensity-modulated proton therapy (IMPT) plans with robustly optimized IMPT plans using the robust optimization tools available in Pinnacle Treatment Planning System. We performed the study in five cases of different anatomic sites (brain, head and neck, lung, pancreas, and prostate). Pinnacle IMPT nonclinical version was used for IMPT planning. Two types of IMPT plans were created for each case. One is PTV-based conventionally optimized IMPT plan and the other is robustly optimized plan considering setup uncertainties. For the PTV-based plans, margins were on top of clinical target volume (CTV) to account for the setup errors, whereas in the robustly optimized plan, the setup errors were directly incorporated into the optimization process. The plan evaluation included target (CTV) coverage and dose uniformity. Our interest was to see how the target coverage and dose uniformity were perturbed on imposing setup errors in +X, -X, +Y, -Y, +Z, and -Z directions for both PTV-based and robust optimization (RO)-based plans. On the average, RO-based IMPT plans have shown a good consistency of target coverage and dose uniformity for all six setup errors scenarios as compared to PTV-based plans. In addition, RO-based plans have a better target coverage and dose uniformity under uncertainty conditions as compared to the PTV-based plans. The study demonstrates the superiority of robustly optimized IMPT plans over the PTV-based IMPT plans in terms of dose distribution under the uncertainty conditions.
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http://dx.doi.org/10.4103/jmp.JMP_45_18 | DOI Listing |
J Radiat Res
December 2024
Section of Radiation Safety and Quality Assurance, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
We assessed the effect of beam size on plan robustness for intensity-modulated proton therapy (IMPT) of head and neck cancer (HNC) and compared the plan quality including robustness with that of intensity-modulated radiation therapy (IMRT). IMPT plans were generated for six HNC patients using six beam sizes (air-sigma 3-17 mm at isocenter for a 70-230 MeV) and two optimization methods for planning target volume-based non-robust optimization (NRO) and clinical target volume (CTV)-based robust optimization (RO). Worst-case dosimetric parameters and plan robustness for CTV and organs-at-risk (OARs) were assessed under different scenarios, assuming a ± 1-5 mm setup error and a ± 3% range error.
View Article and Find Full Text PDFJ Appl Clin Med Phys
December 2024
Department of Radiation Oncology, Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida, Boca Raton, Florida, USA.
Purpose: A novel proton beam delivery method known as DynamicARC spot scanning has been introduced. The current study aims to determine whether the partial proton arc technique, in conjunction with DynamicARC pencil beam scanning (PBS), can meet clinical acceptance criteria for bilateral head and neck cancer (HNC) and provide an alternative to full proton arc and traditional intensity-modulated proton therapy (IMPT).
Method: The study retrospectively included anonymized CT datasets from ten patients with bilateral HNC, all of whom had previously received photon treatment.
ArXiv
November 2024
Department of Radiation Oncology, University of Kansas Medical Center, USA.
Background: Intensity-modulated proton therapy (IMPT) using pencil beam technique scans tumor in a layer by layer, then spot by spot manner. It can provide highly conformal dose to tumor targets and spare nearby organs-at-risk (OAR). Fast delivery of IMPT can improve patient comfort and reduce motion-induced uncertainties.
View Article and Find Full Text PDFMed Phys
December 2024
Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA.
Phys Med
December 2024
Department of Radiation Oncology, Lynn Cancer Institute, Boca Raton Regional Hospital, Baptist Health South Florida, Boca Raton, FL, USA.
Purpose: This study aims to compare the dosimetric impact of incorporating systematic and random setup uncertainties in the robust optimization of head and neck cancer (HNC) Intensity Modulated Proton Therapy (IMPT) plans.
Methods: Bilateral HNC patients (n = 10) previously treated with conventional photon therapy at our institution were included. Both systematic and random setup uncertainties were incorporated into the robust optimization process of IMPT planning.
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