4D Proton treatment planning strategy for mobile lung tumors

Journal Article · Thu Mar 01 04:00:00 EST 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.10.045· OSTI ID:20944745

Yixiu, Kang ^[1]; Xiaodong, Zhang ^[1]; Chang, Joe Y ^[2]; He, Wang ^[1]; Xiong, Wei ^[2]; Zhongxing, Liao ^[2]; Komaki, Ritsuko ^[2]; Cox, James D ^[2]; Balter, Peter A ^[1]; Liu, Helen ^[1]; Zhu, X Ronald ^[1]; Mohan, Radhe ^[1]; Lei, Dong ^[1]

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1. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
2. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

Purpose: To investigate strategies for designing compensator-based 3D proton treatment plans for mobile lung tumors using four-dimensional computed tomography (4DCT) images. Methods and Materials: Four-dimensional CT sets for 10 lung cancer patients were used in this study. The internal gross tumor volume (IGTV) was obtained by combining the tumor volumes at different phases of the respiratory cycle. For each patient, we evaluated four planning strategies based on the following dose calculations: (1) the average (AVE) CT; (2) the free-breathing (FB) CT; (3) the maximum intensity projection (MIP) CT; and (4) the AVE CT in which the CT voxel values inside the IGTV were replaced by a constant density (AVE{sub R}IGTV). For each strategy, the resulting cumulative dose distribution in a respiratory cycle was determined using a deformable image registration method. Results: There were dosimetric differences between the apparent dose distribution, calculated on a single CT dataset, and the motion-corrected 4D dose distribution, calculated by combining dose distributions delivered to each phase of the 4DCT. The AVE{sub R}IGTV plan using a 1-cm smearing parameter had the best overall target coverage and critical structure sparing. The MIP plan approach resulted in an unnecessarily large treatment volume. The AVE and FB plans using 1-cm smearing did not provide adequate 4D target coverage in all patients. By using a larger smearing value, adequate 4D target coverage could be achieved; however, critical organ doses were increased. Conclusion: The AVE{sub R}IGTV approach is an effective strategy for designing proton treatment plans for mobile lung tumors.

• OSTI ID: 20944745
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 67; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
COMPUTERIZED TOMOGRAPHY
IMAGES
LUNGS
PATIENTS
PLANNING
PROTON BEAMS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RESPIRATION