Effects of anatomical changes on pencil beam scanning proton plans in locally advanced NSCLC patients
| Autor: | Simon van Kranen, Jan-Jakob Sonke, Yenny Z. Szeto, Marnix G. Witte, José Belderbos, Marcel van Herk |
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| Přispěvatelé: | Biomedical Engineering and Physics |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Lung Neoplasms Locally advanced Computed tomography 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Adaptive planning Planned Dose Carcinoma Non-Small-Cell Lung Proton Therapy medicine Humans Radiology Nuclear Medicine and imaging Four-Dimensional Computed Tomography Radiometry Radionuclide Imaging Pencil-beam scanning Proton therapy Manchester Cancer Research Centre medicine.diagnostic_test business.industry ResearchInstitutes_Networks_Beacons/mcrc Radiotherapy Planning Computer-Assisted Respiratory motion Uncertainty Hematology Oncology Treatment dose 030220 oncology & carcinogenesis Respiratory Mechanics Radiology Nuclear medicine business |
| Zdroj: | Radiotherapy and oncology, 120(2), 286-292. Elsevier Ireland Ltd Szeto, Y Z, Witte, M G, van Kranen, S R, Sonke, J-J, Belderbos, J & van Herk, M 2016, ' Effects of anatomical changes on pencil beam scanning proton plans in locally advanced NSCLC patients ', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology . https://doi.org/10.1016/j.radonc.2016.04.002 |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2016.04.002 |
| Popis: | BACKGROUND AND PURPOSE: Daily anatomical variations can cause considerable differences between delivered and planned dose. This study simulates and evaluates these effects in spot-scanning proton therapy for lung cancer patients.MATERIALS AND METHODS: Robust intensity modulated treatment plans were designed on the mid-position CT scan for sixteen locally advanced lung cancer patients. To estimate dosimetric uncertainty, deformable registration was performed on their daily CBCTs to generate 4DCT equivalent scans for each fraction and to map recomputed dose to a common frame.RESULTS: Without adaptive planning, eight patients had an undercoverage of the targets of more than 2GyE (maximum of 14.1GyE) on the recalculated treatment dose from the daily anatomy variations including respiration. In organs at risk, a maximum increase of 4.7GyE in the D1 was found in the mediastinal structures. The effect of respiratory motion alone is smaller: 1.4GyE undercoverage for targets and less than 1GyE for organs at risk.CONCLUSIONS: Daily anatomical variations over the course of treatment can cause considerable dose differences in the robust planned dose distribution. An advanced planning strategy including knowledge of anatomical uncertainties would be recommended to improve plan robustness against interfractional variations. For large anatomical changes, adaptive therapy is mandatory. |
| Databáze: | OpenAIRE |
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