scholarly journals Functional avoidance‐based intensity modulated proton therapy with 4DCT derived ventilation imaging for lung cancer

2021 ◽  
Author(s):  
Jingjing M. Dougherty ◽  
Edward Castillo ◽  
Richard Castillo ◽  
Austin M. Faught ◽  
Mark Pepin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Proton Therapy ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Ventilation Imaging

scholarly journals Robustness and Organ Sparing Potential of Intensity Modulated Proton Therapy for Lung Cancer

2018 ◽  
Vol 102 (3) ◽  
pp. S56-S57
Author(s):  
H.P. van der Laan ◽  
M. Anakotta ◽  
E.W. Korevaar ◽  
M. Dieters ◽  
J.F. Ubbels ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Proton Therapy ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Organ Sparing

scholarly journals Is an analytical dose engine sufficient for intensity modulated proton therapy in lung cancer?

2020 ◽  
Vol 93 (1107) ◽  
pp. 20190583 ◽  
Author(s):  
Suliana Teoh ◽  
Francesca Fiorini ◽  
Ben George ◽  
Katherine A Vallis ◽  
Frank Van den Heuvel
Keyword(s):  
Lung Cancer ◽  
Proton Therapy ◽  
Dose Calculation ◽  
Target Volume ◽  
Pass Rates ◽  
Final Dose ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Mediastinal Disease ◽  
Mediastinal Involvement

Objective: To identify a subgroup of lung cancer plans where the analytical dose calculation (ADC) algorithm may be clinically acceptable compared to Monte Carlo (MC) dose calculation in intensity modulated proton therapy (IMPT). Methods: Robust-optimised IMPT plans were generated for 20 patients to a dose of 70 Gy (relative biological effectiveness) in 35 fractions in Raystation. For each case, four plans were generated: three with ADC optimisation using the pencil beam (PB) algorithm followed by a final dose calculation with the following algorithms: PB (PB-PB), MC (PB-MC) and MC normalised to prescription dose (PB-MC scaled). A fourth plan was generated where MC optimisation and final dose calculation was performed (MC-MC). Dose comparison and γ analysis (PB-PB vs PB-MC) at two dose thresholds were performed: 20% (D20) and 99% (D99) with PB-PB plans as reference. Results: Overestimation of the dose to 99% and mean dose of the clinical target volume was observed in all PB-MC compared to PB-PB plans (median: 3.7 Gy(RBE) (5%) (range: 2.3 to 6.9 Gy(RBE)) and 1.8 Gy(RBE) (3%) (0.5 to 4.6 Gy(RBE))). PB-MC scaled plans resulted in significantly higher CTVD2 compared to PB-PB (median difference: −4 Gy(RBE) (−6%) (-5.3 to −2.4 Gy(RBE)), p ≤ .001). The overall median γ pass rates (3%–3 mm) at D20 and D99 were 93.2% (range:62.2–97.5%) and 71.3 (15.4–92.0%). On multivariate analysis, presence of mediastinal disease and absence of range shifters were significantly associated with high γ pass rates. Median D20 and D99 pass rates with these predictors were 96.0% (95.3–97.5%) and 85.4% (75.1–92.0%). MC-MC achieved similar target coverage and doses to OAR compared to PB-PB plans. Conclusion: In the presence of mediastinal involvement and absence of range shifters Raystation ADC may be clinically acceptable in lung IMPT. Otherwise, MC algorithm would be recommended to ensure accuracy of treatment plans. Advances in knowledge: Although MC algorithm is more accurate compared to ADC in lung IMPT, ADC may be clinically acceptable where there is mediastinal involvement and absence of range shifters.

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