skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: SU-F-T-123: The Simulated Effect of the Breath-Hold Reproducibility Treating Locally-Advanced Lung Cancer with Pencil Beam Scanned Proton Therapy

Abstract

Purpose: The breath-hold (BH) technique has been suggested to mitigate motion and reduce target coverage degradation due to motion effects. The aim of this study was to investigate the effect of inter-BH residual motion on the dose distribution for pencil beam scanned (PBS) proton therapy of locally-advanced lung cancer patients. Methods: A dataset of visually-guided BH CT scans was acquired (10 scans per patient) taken from five lung cancer patients: three intra-fractionally repeated CT scans on treatment days 2,16 and 31, in addition to the day 0 planning CT scan. Three field intensity-modulated proton therapy (IMPT) plans were constructed on the planning CT scan. Dose delivery on fraction 2, 16 and 31 were simulated on the three consecutive CT scans, assuming BH duration of 20s and soft tissue match. The dose was accumulated in the planning CT using deformable image registration, and scaled to simulate the full treatment of 66Gy(RBE) in 33 fractions. Results: The mean dose to the lungs and heart, and maximum dose to the spinal cord and esophagus were within 1% of the planned dose. The CTV V95% decreased and the inhomogeneity (D5%–D95%) increased on average 4.1% (0.4–12.2%) and 5.8% (2.2–13.4%), respectively, over the five patient cases.more » Conclusion: The results showed that the BH technique seems to spare the OARs in spite of inter-BH residual motion. However, small degradation of target coverage occurred for all patients, with 3/5 patients having a decrease in V95% ≤1%. For the remaining two patients, where V95% decreased up to 12%, the cause could be related to treatment related anatomical changes and, as in photon therapy, plan adaptation may be necessary to ensure target coverage. This study showed that BH could be a potential treatment option to reliably mitigate motion for the treatment of locally-advanced lung cancer using PBS proton therapy.« less

Authors:
 [1];  [2];  [2];  [1]; ;  [3];  [1];  [4]; ;  [3];  [2];  [1];  [4];
  1. Paul Scherrer Institut, Villigen PSI (Switzerland)
  2. (Denmark)
  3. Department of Oncology, Rigshospitalet, Copenhagen (Denmark)
  4. (Switzerland)
Publication Date:
OSTI Identifier:
22642364
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 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; 61 RADIATION PROTECTION AND DOSIMETRY; COMPUTERIZED TOMOGRAPHY; LUNGS; NEOPLASMS; PATIENTS; PLANNING; PROTON BEAMS; RADIATION DOSE DISTRIBUTIONS; RADIOTHERAPY; SIMULATION; SPINAL CORD

Citation Formats

Dueck, J, Department of Oncology, Rigshospitalet, Copenhagen, Niels Bohr Institute, University of Copenhagen, Copenhagen, Perrin, R, Persson, G F, Engelholm, S A, Lomax, A, Department of Physics, ETH, Zürich, Josipovic, M, Rosenschöld, AF, Niels Bohr Institute, University of Copenhagen, Copenhagen, Weber, D C, University of Zürich, Zürich, and Munck, P. SU-F-T-123: The Simulated Effect of the Breath-Hold Reproducibility Treating Locally-Advanced Lung Cancer with Pencil Beam Scanned Proton Therapy. United States: N. p., 2016. Web. doi:10.1118/1.4956259.
Dueck, J, Department of Oncology, Rigshospitalet, Copenhagen, Niels Bohr Institute, University of Copenhagen, Copenhagen, Perrin, R, Persson, G F, Engelholm, S A, Lomax, A, Department of Physics, ETH, Zürich, Josipovic, M, Rosenschöld, AF, Niels Bohr Institute, University of Copenhagen, Copenhagen, Weber, D C, University of Zürich, Zürich, & Munck, P. SU-F-T-123: The Simulated Effect of the Breath-Hold Reproducibility Treating Locally-Advanced Lung Cancer with Pencil Beam Scanned Proton Therapy. United States. doi:10.1118/1.4956259.
Dueck, J, Department of Oncology, Rigshospitalet, Copenhagen, Niels Bohr Institute, University of Copenhagen, Copenhagen, Perrin, R, Persson, G F, Engelholm, S A, Lomax, A, Department of Physics, ETH, Zürich, Josipovic, M, Rosenschöld, AF, Niels Bohr Institute, University of Copenhagen, Copenhagen, Weber, D C, University of Zürich, Zürich, and Munck, P. Wed . "SU-F-T-123: The Simulated Effect of the Breath-Hold Reproducibility Treating Locally-Advanced Lung Cancer with Pencil Beam Scanned Proton Therapy". United States. doi:10.1118/1.4956259.
@article{osti_22642364,
title = {SU-F-T-123: The Simulated Effect of the Breath-Hold Reproducibility Treating Locally-Advanced Lung Cancer with Pencil Beam Scanned Proton Therapy},
author = {Dueck, J and Department of Oncology, Rigshospitalet, Copenhagen and Niels Bohr Institute, University of Copenhagen, Copenhagen and Perrin, R and Persson, G F and Engelholm, S A and Lomax, A and Department of Physics, ETH, Zürich and Josipovic, M and Rosenschöld, AF and Niels Bohr Institute, University of Copenhagen, Copenhagen and Weber, D C and University of Zürich, Zürich and Munck, P},
abstractNote = {Purpose: The breath-hold (BH) technique has been suggested to mitigate motion and reduce target coverage degradation due to motion effects. The aim of this study was to investigate the effect of inter-BH residual motion on the dose distribution for pencil beam scanned (PBS) proton therapy of locally-advanced lung cancer patients. Methods: A dataset of visually-guided BH CT scans was acquired (10 scans per patient) taken from five lung cancer patients: three intra-fractionally repeated CT scans on treatment days 2,16 and 31, in addition to the day 0 planning CT scan. Three field intensity-modulated proton therapy (IMPT) plans were constructed on the planning CT scan. Dose delivery on fraction 2, 16 and 31 were simulated on the three consecutive CT scans, assuming BH duration of 20s and soft tissue match. The dose was accumulated in the planning CT using deformable image registration, and scaled to simulate the full treatment of 66Gy(RBE) in 33 fractions. Results: The mean dose to the lungs and heart, and maximum dose to the spinal cord and esophagus were within 1% of the planned dose. The CTV V95% decreased and the inhomogeneity (D5%–D95%) increased on average 4.1% (0.4–12.2%) and 5.8% (2.2–13.4%), respectively, over the five patient cases. Conclusion: The results showed that the BH technique seems to spare the OARs in spite of inter-BH residual motion. However, small degradation of target coverage occurred for all patients, with 3/5 patients having a decrease in V95% ≤1%. For the remaining two patients, where V95% decreased up to 12%, the cause could be related to treatment related anatomical changes and, as in photon therapy, plan adaptation may be necessary to ensure target coverage. This study showed that BH could be a potential treatment option to reliably mitigate motion for the treatment of locally-advanced lung cancer using PBS proton therapy.},
doi = {10.1118/1.4956259},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}