Multi-scenario based robust intensity-modulated proton therapy (IMPT) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (PTV) based intensity-modulated photon plans in the head and neck region

BACKGROUND: In a previous report, we compared the conformity of robust intensity-modulated proton therapy (IMPT) plans with that of helical tomotherapy plans for re-irradiations of head and neck carcinomas using a fixed set-up error of 2 mm. Here, we varied the maximum set-up errors between 0 and 5 ...

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Autores principales: Stuschke, Martin, Kaiser, Andreas, Jawad, Jehad Abu, Pöttgen, Christoph, Levegrün, Sabine, Farr, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3695849/
https://www.ncbi.nlm.nih.gov/pubmed/23773560
http://dx.doi.org/10.1186/1748-717X-8-145
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author Stuschke, Martin
Kaiser, Andreas
Jawad, Jehad Abu
Pöttgen, Christoph
Levegrün, Sabine
Farr, Jonathan
author_facet Stuschke, Martin
Kaiser, Andreas
Jawad, Jehad Abu
Pöttgen, Christoph
Levegrün, Sabine
Farr, Jonathan
author_sort Stuschke, Martin
collection PubMed
description BACKGROUND: In a previous report, we compared the conformity of robust intensity-modulated proton therapy (IMPT) plans with that of helical tomotherapy plans for re-irradiations of head and neck carcinomas using a fixed set-up error of 2 mm. Here, we varied the maximum set-up errors between 0 and 5 mm and compared the robust IMPT-plans with planning target volume (PTV) based intensity-modulated photon therapy (IMRT). FINDINGS: Seven patients were treated with a PTV-based tomotherapy plan. Set-up margins of 0, 2, and 5 mm were subtracted from the PTV to generate target volumes (TV) TV(0mm), TV(2mm), and TV(5mm), for which robust IMPT-plans were created assuming range uncertainties of ±3.5% and using worst case optimization assuming set-up errors of 0, 2, and 5 mm, respectively. Robust optimization makes use of the feature that set-up errors in beam direction alone do not affect the distal and proximal margin for that beam. With increasing set-up errors, the body volumes that were exposed to a selected minimum dose level between 20% and 95% of the prescribed dose decreased. In IMPT-plans with 0 mm set-up error, the exposed body volumes were on average 6.2% ± 0.9% larger than for IMPT-plans with 2 mm set-up error, independent of the considered dose level (p < 0.0001, F-test). In IMPT-plans accounting for 5 mm set-up error, the exposed body volumes were by 11.9% ± 0.8% smaller than for IMPT-plans with 2 mm set-up error at a fixed minimum dose (p < 0.0001, F-test). This set-up error dependence of the normal tissue exposure around the TV in robust IMPT-plans corresponding to the same IMRT-plan led to a decrease in the mean dose to the temporal lobes and the cerebellum, and in the D2% of the brain stem or spinal cord with increasing set-up errors considered during robust IMPT-planning. CONCLUSIONS: For recurrent head and neck cancer, robust IMPT-plan optimization led to a decrease in normal tissue exposure with increasing set-up error for target volumes corresponding to the same PTV.
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spelling pubmed-36958492013-06-29 Multi-scenario based robust intensity-modulated proton therapy (IMPT) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (PTV) based intensity-modulated photon plans in the head and neck region Stuschke, Martin Kaiser, Andreas Jawad, Jehad Abu Pöttgen, Christoph Levegrün, Sabine Farr, Jonathan Radiat Oncol Short Report BACKGROUND: In a previous report, we compared the conformity of robust intensity-modulated proton therapy (IMPT) plans with that of helical tomotherapy plans for re-irradiations of head and neck carcinomas using a fixed set-up error of 2 mm. Here, we varied the maximum set-up errors between 0 and 5 mm and compared the robust IMPT-plans with planning target volume (PTV) based intensity-modulated photon therapy (IMRT). FINDINGS: Seven patients were treated with a PTV-based tomotherapy plan. Set-up margins of 0, 2, and 5 mm were subtracted from the PTV to generate target volumes (TV) TV(0mm), TV(2mm), and TV(5mm), for which robust IMPT-plans were created assuming range uncertainties of ±3.5% and using worst case optimization assuming set-up errors of 0, 2, and 5 mm, respectively. Robust optimization makes use of the feature that set-up errors in beam direction alone do not affect the distal and proximal margin for that beam. With increasing set-up errors, the body volumes that were exposed to a selected minimum dose level between 20% and 95% of the prescribed dose decreased. In IMPT-plans with 0 mm set-up error, the exposed body volumes were on average 6.2% ± 0.9% larger than for IMPT-plans with 2 mm set-up error, independent of the considered dose level (p < 0.0001, F-test). In IMPT-plans accounting for 5 mm set-up error, the exposed body volumes were by 11.9% ± 0.8% smaller than for IMPT-plans with 2 mm set-up error at a fixed minimum dose (p < 0.0001, F-test). This set-up error dependence of the normal tissue exposure around the TV in robust IMPT-plans corresponding to the same IMRT-plan led to a decrease in the mean dose to the temporal lobes and the cerebellum, and in the D2% of the brain stem or spinal cord with increasing set-up errors considered during robust IMPT-planning. CONCLUSIONS: For recurrent head and neck cancer, robust IMPT-plan optimization led to a decrease in normal tissue exposure with increasing set-up error for target volumes corresponding to the same PTV. BioMed Central 2013-06-18 /pmc/articles/PMC3695849/ /pubmed/23773560 http://dx.doi.org/10.1186/1748-717X-8-145 Text en Copyright © 2013 Stuschke et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Report
Stuschke, Martin
Kaiser, Andreas
Jawad, Jehad Abu
Pöttgen, Christoph
Levegrün, Sabine
Farr, Jonathan
Multi-scenario based robust intensity-modulated proton therapy (IMPT) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (PTV) based intensity-modulated photon plans in the head and neck region
title Multi-scenario based robust intensity-modulated proton therapy (IMPT) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (PTV) based intensity-modulated photon plans in the head and neck region
title_full Multi-scenario based robust intensity-modulated proton therapy (IMPT) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (PTV) based intensity-modulated photon plans in the head and neck region
title_fullStr Multi-scenario based robust intensity-modulated proton therapy (IMPT) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (PTV) based intensity-modulated photon plans in the head and neck region
title_full_unstemmed Multi-scenario based robust intensity-modulated proton therapy (IMPT) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (PTV) based intensity-modulated photon plans in the head and neck region
title_short Multi-scenario based robust intensity-modulated proton therapy (IMPT) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (PTV) based intensity-modulated photon plans in the head and neck region
title_sort multi-scenario based robust intensity-modulated proton therapy (impt) plans can account for set-up errors more effectively in terms of normal tissue sparing than planning target volume (ptv) based intensity-modulated photon plans in the head and neck region
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3695849/
https://www.ncbi.nlm.nih.gov/pubmed/23773560
http://dx.doi.org/10.1186/1748-717X-8-145
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