Four-Dimensional Patient Dose Reconstruction for Scanned Ion Beam Therapy of Moving Liver Tumors

Journal Article · Thu May 01 00:00:00 EDT 2014 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2014.01.043· OSTI ID:22416561

Richter, Daniel ^[1]; TU Darmstadt, Darmstadt ^[2]; Saito, Nami ^[1]; Chaudhri, Naved ^[3]; Härtig, Martin ^[4]; Ellerbrock, Malte ^[3]; Jäkel, Oliver ^[3]; Combs, Stephanie E.; Habermehl, Daniel; Herfarth, Klaus ^[4]; Durante, Marco ^[1]; TU Darmstadt, Darmstadt ^[2]; Bert, Christoph ^[1]

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1. GSI Helmholtzzentrum für Schwerionenforschung, Department of Biophysics, Darmstadt (Germany)
2. Germany
3. Heidelberg Ion-Beam Therapy Center, Department of Medical Physics, Heidelberg (Germany)
4. University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany)

Purpose: Estimation of the actual delivered 4-dimensional (4D) dose in treatments of patients with mobile hepatocellular cancer with scanned carbon ion beam therapy. Methods and Materials: Six patients were treated with 4 fractions to a total relative biological effectiveness (RBE)–weighted dose of 40 Gy (RBE) using a single field. Respiratory motion was addressed by dedicated margins and abdominal compression (5 patients) or gating (1 patient). 4D treatment dose reconstructions based on the treatment records and the measured motion monitoring data were performed for the single-fraction dose and a total of 17 fractions. To assess the impact of uncertainties in the temporal correlation between motion trajectory and beam delivery sequence, 3 dose distributions for varying temporal correlation were calculated per fraction. For 3 patients, the total treatment dose was formed from the fractional distributions using all possible combinations. Clinical target volume (CTV) coverage was analyzed using the volumes receiving at least 95% (V{sub 95}) and 107% (V{sub 107}) of the planned doses. Results: 4D dose reconstruction based on daily measured data is possible in a clinical setting. V{sub 95} and V{sub 107} values for the single fractions ranged between 72% and 100%, and 0% and 32%, respectively. The estimated total treatment dose to the CTV exhibited improved and more robust dose coverage (mean V{sub 95} > 87%, SD < 3%) and overdose (mean V{sub 107} < 4%, SD < 3%) with respect to the single-fraction dose for all analyzed patients. Conclusions: A considerable impact of interplay effects on the single-fraction CTV dose was found for most of the analyzed patients. However, due to the fractionated treatment, dose heterogeneities were substantially reduced for the total treatment dose. 4D treatment dose reconstruction for scanned ion beam therapy is technically feasible and may evolve into a valuable tool for dose assessment.

• OSTI ID: 22416561
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 89, Issue 1; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARBON IONS
COMPRESSION
CORRELATIONS
FOUR-DIMENSIONAL CALCULATIONS
ION BEAMS
LIVER
MONITORING
NEOPLASMS
PATIENTS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RADIOTHERAPY
RBE