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Preliminary tests of dosimetric quality and projected therapeutic outcomes of multi-phase 4D radiotherapy with proton and carbon ion beams

Lis, Michelle ; Newhauser, Wayne ; Donetti, Marco ; Wolf, Moritz ; Steinsberger, Timo ; Paz, Athena ; Graeff, Christian (2024)
Preliminary tests of dosimetric quality and projected therapeutic outcomes of multi-phase 4D radiotherapy with proton and carbon ion beams.
In: Physics in Medicine & Biology, 2021, 66 (23)
doi: 10.26083/tuprints-00020500
Article, Secondary publication, Publisher's Version

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Item Type: Article
Type of entry: Secondary publication
Title: Preliminary tests of dosimetric quality and projected therapeutic outcomes of multi-phase 4D radiotherapy with proton and carbon ion beams
Language: English
Date: 5 March 2024
Place of Publication: Darmstadt
Year of primary publication: 2021
Place of primary publication: Bristol
Publisher: IOP Publishing
Journal or Publication Title: Physics in Medicine & Biology
Volume of the journal: 66
Issue Number: 23
Collation: 14 Seiten
DOI: 10.26083/tuprints-00020500
Corresponding Links:
Origin: Secondary publication DeepGreen
Abstract:

The purpose of this study was to perform preliminary pre-clinical tests to compare the dosimetric quality of two approaches to treating moving tumors with ion beams: synchronously delivering the beam with the motion of a moving planning target volume (PTV) using the recently developed multi-phase 4D dose delivery (MP4D) approach, and asynchronously delivering the ion beam to a motion-encompassing internal tumor volume (ITV) combined with rescanning. We created 4D optimized treatment plans with proton and carbon ion beams for two patients who had previously received treatment for non-small cell lung cancer. For each patient, we created several treatment plans, using approaches with and without motion mitigation: MP4D, ITV with rescanning, static deliveries to a stationary PTV, and deliveries to a moving tumor without motion compensation. Two sets of plans were optimized with margins or robust uncertainty scenarios. Each treatment plan was delivered using a recently-developed motion-synchronized dose delivery system (M-DDS); dose distributions in water were compared to measurements using gamma index analysis to confirm the accuracy of the calculations. Reconstructed dose distributions on the patient CT were analyzed to assess the dosimetric quality of the deliveries (conformity, uniformity, tumor coverage, and extent of hotspots). Gamma index analysis pass rates confirmed the accuracy of dose calculations. Dose coverage was >95% for all static and MP4D treatments. The best conformity and the lowest lung doses were achieved with MP4D deliveries. Robust optimization led to higher lung doses compared to conventional optimization for ITV deliveries, but not for MP4D deliveries. We compared dosimetric quality for two approaches to treating moving tumors with ion beams. Our findings suggest that the MP4D approach, using an M-DDS, provides conformal motion mitigation, with full target coverage and lower OAR doses.

Uncontrolled Keywords: carbon ion therapy, motion-synchronized, conformal delivery, proton therapy, projected therapeutic outcomes, multi-phase 4D dose delivery
Status: Publisher's Version
URN: urn:nbn:de:tuda-tuprints-205001
Classification DDC: 500 Science and mathematics > 530 Physics
Divisions: 05 Department of Physics > Institute for Condensed Matter Physics
Date Deposited: 05 Mar 2024 12:20
Last Modified: 28 May 2024 06:20
SWORD Depositor: Deep Green
URI: https://tuprints.ulb.tu-darmstadt.de/id/eprint/20500
PPN: 518625850
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