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Title: TU-H-CAMPUS-JeP3-04: Factors Predicting a Need for Treatment Replanning with Proton Radiotherapy for Lung Cancer

Abstract

Purpose: Proton dose distribution is sensitive to tumor regression and tissue and normal anatomy changes. Replanning is sometimes necessary during treatment to ensure continue tumor coverage or avoid overtreatment of organs at risk (OARs). We investigated action thresholds for replanning and identified both dosimetric and non-dosimetric metrics that would predict a need for replan. Methods: All consecutive lung cancer patients (n = 188) who received definitive proton radiotherapy and had more than two evaluation CT scans at the Roberts Proton Therapy Center (Philadelphia, USA) from 2011 to 2015 were included in this study. The cohort included a variety of tumor sizes, locations, histology, beam angles, as well as radiation-induced tumor and lung change. Dosimetric changes during therapy were characterized by changes in the dose volume distribution of PTV, ITV, and OARs (heart, cord, esophagus, brachial plexus and lungs). Tumor and lung change were characterized by changes in sizes, and in the distribution of Hounsfield numbers and water equivalent thickness (WET) along the beam path. We applied machine learning tools to identify both dosimetric and non-dosimetric metrics that predicted a replan. Results: Preliminary data showed that clinical indicators (n = 54) were highly correlated; thus, a simple indicator may be derivedmore » to guide the action threshold for replanning. Additionally, tumor regression alone could not predict dosimetric changes in OARs; it required further information about beam angles and tumor locations. Conclusion: Both dosimetric and non-dosimetric factors are predictive of the need for replanning during proton treatment.« less

Authors:
; ; ; ; ; ; ; ; ; ; ; ;  [1]
  1. University of Pennsylvania, Philadelphia, PA (United States)
Publication Date:
OSTI Identifier:
22654075
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; PROTON BEAMS; RADIATION DOSE DISTRIBUTIONS; RADIOTHERAPY

Citation Formats

Teng, C, Janssens, G, Ainsley, C, Teo, B, Valdes, G, Burgdorf, B, Berman, A, Levin, W, Xiao, Y, Lin, L, Gabriel, P, Simone, C, and Solberg, T. TU-H-CAMPUS-JeP3-04: Factors Predicting a Need for Treatment Replanning with Proton Radiotherapy for Lung Cancer. United States: N. p., 2016. Web. doi:10.1118/1.4957702.
Teng, C, Janssens, G, Ainsley, C, Teo, B, Valdes, G, Burgdorf, B, Berman, A, Levin, W, Xiao, Y, Lin, L, Gabriel, P, Simone, C, & Solberg, T. TU-H-CAMPUS-JeP3-04: Factors Predicting a Need for Treatment Replanning with Proton Radiotherapy for Lung Cancer. United States. doi:10.1118/1.4957702.
Teng, C, Janssens, G, Ainsley, C, Teo, B, Valdes, G, Burgdorf, B, Berman, A, Levin, W, Xiao, Y, Lin, L, Gabriel, P, Simone, C, and Solberg, T. Wed . "TU-H-CAMPUS-JeP3-04: Factors Predicting a Need for Treatment Replanning with Proton Radiotherapy for Lung Cancer". United States. doi:10.1118/1.4957702.
@article{osti_22654075,
title = {TU-H-CAMPUS-JeP3-04: Factors Predicting a Need for Treatment Replanning with Proton Radiotherapy for Lung Cancer},
author = {Teng, C and Janssens, G and Ainsley, C and Teo, B and Valdes, G and Burgdorf, B and Berman, A and Levin, W and Xiao, Y and Lin, L and Gabriel, P and Simone, C and Solberg, T},
abstractNote = {Purpose: Proton dose distribution is sensitive to tumor regression and tissue and normal anatomy changes. Replanning is sometimes necessary during treatment to ensure continue tumor coverage or avoid overtreatment of organs at risk (OARs). We investigated action thresholds for replanning and identified both dosimetric and non-dosimetric metrics that would predict a need for replan. Methods: All consecutive lung cancer patients (n = 188) who received definitive proton radiotherapy and had more than two evaluation CT scans at the Roberts Proton Therapy Center (Philadelphia, USA) from 2011 to 2015 were included in this study. The cohort included a variety of tumor sizes, locations, histology, beam angles, as well as radiation-induced tumor and lung change. Dosimetric changes during therapy were characterized by changes in the dose volume distribution of PTV, ITV, and OARs (heart, cord, esophagus, brachial plexus and lungs). Tumor and lung change were characterized by changes in sizes, and in the distribution of Hounsfield numbers and water equivalent thickness (WET) along the beam path. We applied machine learning tools to identify both dosimetric and non-dosimetric metrics that predicted a replan. Results: Preliminary data showed that clinical indicators (n = 54) were highly correlated; thus, a simple indicator may be derived to guide the action threshold for replanning. Additionally, tumor regression alone could not predict dosimetric changes in OARs; it required further information about beam angles and tumor locations. Conclusion: Both dosimetric and non-dosimetric factors are predictive of the need for replanning during proton treatment.},
doi = {10.1118/1.4957702},
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}
}