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Title: SU-E-T-73: A Robust Proton Beam Therapy Technique for High-Risk Prostate Cancer Whole Pelvis Irradiation: Bilateral Opposed Single Field Uniform Dose (SFUD) Plan with Lateral Penumbra Gradient Matching

Abstract

Purpose: To develop a clinical feasible and robust proton therapy technique to spare bowel, bladder and rectum for high-risk prostate cancer patients Methods: The study includes 3 high-risk prostate cancer cases treated with bilateral opposed SFUD with lateral penumbra gradient matching technique prescribed to 5400cGyE in 30 fx in our institution. To treat whole pelvic lymph node chain, the complicated ‘H’ shape, using SFUD technique, we divided the target into two sub-targets (LLAT beam treating ‘90 degree T-shape’ and RLAT beam treating ‘: shape’) in Plan A and use lateral penumbra gradient matching at patient’s left side. Vice verse in Plan B. Each plan deliver half of the prescription dose. Beam-specific PTVs were created to take range uncertainty and setup error into account. For daily treatment, patient received four fields from both plan A and B per day. Robustness evaluation were performed in the worst case scenario with 3.5% range uncertainty and 1, 2, 3mm overlap or gap between LLAT and RLAT field matching in Raystation 4.0. All of cases also have a Tomotherapy backup plan approved by physician as a dosimetric comparison. Results: The total treatment time take 15–20mins including IGRT and four fields delivery on ProteusONE, a compactmore » size PBS proton system, compared to 25–30min in traditional Tomotherapy. Robustness analysis shows that this plan technique is insensitive to the range uncertainties. With the lateral gradient matching, 1, 2, 3mm overlap renders only 2.5%, 5.5% and 8% hot or cool spot in the junction areas. Dosimetric comparisons with Tomotherapy show a significant dose reduction in bladder D50%(14.7±9.3Gy), D35%(7.3±5.8Gy); small bowel and rectum average dose(19.6±7.5Gy and 14.5±6.3Gy respectively). Conclusion: The bilateral opposed(SFUD) plan with lateral penumbra gradient matching has been approved to be a safe, robust and efficient treatment option for whole pelvis high-risk prostate cancer patient which significantly spares the OARs.« less

Authors:
; ;  [1]
  1. willis knighton medical center, Shreveport, LA (United States)
Publication Date:
OSTI Identifier:
22545203
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 42; Journal Issue: 6; Other Information: (c) 2015 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; BLADDER; COMPUTERIZED TOMOGRAPHY; CT-GUIDED RADIOTHERAPY; IRRADIATION; LYMPH; LYMPH NODES; NEOPLASMS; PATIENTS; PELVIS; PROSTATE; PROTON BEAMS; RADIATION DOSES; RECTUM

Citation Formats

Ding, X, Wu, H, and Rosen, L. SU-E-T-73: A Robust Proton Beam Therapy Technique for High-Risk Prostate Cancer Whole Pelvis Irradiation: Bilateral Opposed Single Field Uniform Dose (SFUD) Plan with Lateral Penumbra Gradient Matching. United States: N. p., 2015. Web. doi:10.1118/1.4924434.
Ding, X, Wu, H, & Rosen, L. SU-E-T-73: A Robust Proton Beam Therapy Technique for High-Risk Prostate Cancer Whole Pelvis Irradiation: Bilateral Opposed Single Field Uniform Dose (SFUD) Plan with Lateral Penumbra Gradient Matching. United States. doi:10.1118/1.4924434.
Ding, X, Wu, H, and Rosen, L. Mon . "SU-E-T-73: A Robust Proton Beam Therapy Technique for High-Risk Prostate Cancer Whole Pelvis Irradiation: Bilateral Opposed Single Field Uniform Dose (SFUD) Plan with Lateral Penumbra Gradient Matching". United States. doi:10.1118/1.4924434.
@article{osti_22545203,
title = {SU-E-T-73: A Robust Proton Beam Therapy Technique for High-Risk Prostate Cancer Whole Pelvis Irradiation: Bilateral Opposed Single Field Uniform Dose (SFUD) Plan with Lateral Penumbra Gradient Matching},
author = {Ding, X and Wu, H and Rosen, L},
abstractNote = {Purpose: To develop a clinical feasible and robust proton therapy technique to spare bowel, bladder and rectum for high-risk prostate cancer patients Methods: The study includes 3 high-risk prostate cancer cases treated with bilateral opposed SFUD with lateral penumbra gradient matching technique prescribed to 5400cGyE in 30 fx in our institution. To treat whole pelvic lymph node chain, the complicated ‘H’ shape, using SFUD technique, we divided the target into two sub-targets (LLAT beam treating ‘90 degree T-shape’ and RLAT beam treating ‘: shape’) in Plan A and use lateral penumbra gradient matching at patient’s left side. Vice verse in Plan B. Each plan deliver half of the prescription dose. Beam-specific PTVs were created to take range uncertainty and setup error into account. For daily treatment, patient received four fields from both plan A and B per day. Robustness evaluation were performed in the worst case scenario with 3.5% range uncertainty and 1, 2, 3mm overlap or gap between LLAT and RLAT field matching in Raystation 4.0. All of cases also have a Tomotherapy backup plan approved by physician as a dosimetric comparison. Results: The total treatment time take 15–20mins including IGRT and four fields delivery on ProteusONE, a compact size PBS proton system, compared to 25–30min in traditional Tomotherapy. Robustness analysis shows that this plan technique is insensitive to the range uncertainties. With the lateral gradient matching, 1, 2, 3mm overlap renders only 2.5%, 5.5% and 8% hot or cool spot in the junction areas. Dosimetric comparisons with Tomotherapy show a significant dose reduction in bladder D50%(14.7±9.3Gy), D35%(7.3±5.8Gy); small bowel and rectum average dose(19.6±7.5Gy and 14.5±6.3Gy respectively). Conclusion: The bilateral opposed(SFUD) plan with lateral penumbra gradient matching has been approved to be a safe, robust and efficient treatment option for whole pelvis high-risk prostate cancer patient which significantly spares the OARs.},
doi = {10.1118/1.4924434},
journal = {Medical Physics},
number = 6,
volume = 42,
place = {United States},
year = {Mon Jun 15 00:00:00 EDT 2015},
month = {Mon Jun 15 00:00:00 EDT 2015}
}