A pilot study on the comparison between planning target volume-based intensity-modulated proton therapy plans and robustly optimized intensity-modulated proton therapy plans

Autor: Bojarajan Perumal, Harikrishna Etti Sundaresan, Ranganathan Vaitheeswaran
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Journal of Medical Physics, Vol 43, Iss 3, Pp 179-184 (2018)
Druh dokumentu: article
ISSN: 0971-6203
1998-3913
DOI: 10.4103/jmp.JMP_45_18
Popis: 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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