Kill painting of hypoxic tumors with multiple ion beams
Kill painting of hypoxic tumors with multiple ion beams
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DOI：
10.1088/1361-6560/aafe40
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发表时间：
2019-02-01
影响因子：
3.5
通讯作者：
Scifoni, E.
中科院分区：
文献类型：
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作者：
Sokol, O.;Kraemer, M.;Scifoni, E.
我们报告了一种新的方法，同时使用多个离子物种的缺氧肿瘤的治疗计划的生物优化。我们以前介绍的杀死绘画方法，其中整体细胞杀死生物异质性目标进行了优化，扩展了同时处理不同离子束的能力。研究治疗计划系统TRiP 98的当前版本（MIBO）现已得到增强，可处理3D（逐体素）目标氧合数据。我们提出了一个理想化的几何形状的情况下，这种方法可以确定最佳的组合，导致一个改进的峰-入口有效剂量比。这是通过粒子注量的重新分配来实现的，此时较重的离子优先转发到缺氧目标区域，而较轻的离子将剩余剂量传递到其含氧正常的区域。最后，我们提出了一个硅颅底脉络膜患者的病例研究与He-4和O-16光束的组合，证明其潜在的临床应用的具体适应症。在这种特殊情况下，与纯He-4和O-16计划相比，脑干接受的平均剂量分别减少了3%-5%和10%-12%。新方法允许不同离子束的完全生物优化，利用现代粒子治疗中心的主动扫描离子束的能力。本方法的可能的实验验证，在离子束设施处理快离子开关的介绍和讨论。
We report on a novel method for simultaneous biological optimization of treatment plans for hypoxic tumors using multiple ion species. Our previously introduced kill painting approach, where the overall cell killing is optimized on biologically heterogeneous targets, was expanded with the capability of handling different ion beams simultaneously. The current version (MIBO) of the research treatment planning system TRiP98 has now been augmented to handle 3D (voxel-by-voxel) target oxygenation data. We present a case of idealized geometries where this method can identify optimal combinations leading to an improved peak-to-entrance effective dose ratio. This is achieved by the redistribution of particle fluences, when the heavier ions are preferentially forwarded to hypoxic target areas, while the lighter ions deliver the remaining dose to its normoxic regions. Finally, we present an in silico skull base chordoma patient case study with a combination of He-4 and O-16 beams, demonstrating specific indications for its potential clinical application. In this particular case, the mean dose, received by the brainstem, was reduced by 3%-5% and by 10%-12% as compared to the pure He-4 and O-16 plans, respectively. The new method allows a full biological optimization of different ion beams, exploiting the capabilities of actively scanned ion beams of modern particle therapy centers. The possible experimental verification of the present approach at ion beam facilities disposing of fast ion switch is presented and discussed.