Worst case optimization for interfractional motion mitigation in carbon ion therapy of pancreatic cancer.
Worst case optimization for interfractional motion mitigation in carbon ion therapy of pancreatic cancer.
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DOI：
10.1186/s13014-016-0705-8
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发表时间：
2016-10-07
期刊：
影响因子：
--
通讯作者：
Bangert M
中科院分区：
文献类型：
--
作者：
Steitz J;Naumann P;Ulrich S;Haefner MF;Sterzing F;Oelfke U;Bangert M
胰腺癌放射治疗的效果受到腹部运动的影响，这限制了剂量递送的空间准确性，尤其是粒子。在这项工作中，我们研究了胰腺癌碳离子治疗中最坏情况优化的潜力。我们实现了一种最坏情况优化算法，该算法明确地模拟了逆规划期间碳离子的相对生物有效性。我们对7名胰腺癌患者进行了比较治疗计划研究。将使用最坏情况优化生成的治疗方案与(1)常规调强碳离子治疗，(2)单场均匀剂量碳离子治疗，以及(3)依赖每日重新规划的理想但不切实际的方案进行比较。剂量学质量和由此产生的治疗方案的稳健性是通过在分数对照ct上重建每日递送剂量分布来评估的。理想的每日重新规划始终提供最佳的剂量学结果，包括靶覆盖和危险器官的保留。在分次剂量重建期间，总体肿瘤体积内d95的绝对减少在常规调强碳离子治疗中最为明显。单场均匀剂量优化对7名患者中的6名没有显著降低，最坏情况优化的d95值介于两者之间。与常规优化和单场均匀剂量优化相比，通过最坏情况优化，总肿瘤体积外的治疗体积（95%处方剂量）减少了两倍。单场均匀剂量优化是在正常组织的辐射暴露增加的情况下产生的，例如，与常规和最坏情况优化相比，肾脏的平均剂量≈2 Gy (RBE)，与最坏情况优化相比，脊髓d1的剂量≈4 Gy （RBE）。分数间运动实质上恶化了胰腺癌患者碳离子治疗的剂量分布。单场均匀剂量优化减轻了运动对正常组织辐射暴露增加时靶覆盖的负面影响。最坏情况下的优化使得在逆向治疗计划中，在超出边际概念的情况下，能够探索健壮的目标覆盖和器官风险保护之间的权衡。
The efficacy of radiation therapy treatments for pancreatic cancer is compromised by abdominal motion which limits the spatial accuracy for dose delivery - especially for particles. In this work we investigate the potential of worst case optimization for interfractional offline motion mitigation in carbon ion treatments of pancreatic cancer. We implement a worst case optimization algorithm that explicitly models the relative biological effectiveness of carbon ions during inverse planning. We perform a comparative treatment planning study for seven pancreatic cancer patients. Treatment plans that have been generated using worst case optimization are compared against (1) conventional intensity-modulated carbon ion therapy, (2) single field uniform dose carbon ion therapy, and (3) an ideal yet impractical scenario relying on daily re-planning. The dosimetric quality and robustness of the resulting treatment plans is evaluated using reconstructions of the daily delivered dose distributions on fractional control CTs. Idealized daily re-planning consistently gives the best dosimetric results with regard to both target coverage and organ at risk sparing. The absolute reduction of D 95 within the gross tumor volume during fractional dose reconstruction is most pronounced for conventional intensity-modulated carbon ion therapy. Single field uniform dose optimization exhibits no substantial reduction for six of seven patients and values for D 95 for worst case optimization fall in between. The treated volume (D>95 % prescription dose) outside of the gross tumor volume is reduced by a factor of two by worst case optimization compared to conventional optimization and single field uniform dose optimization. Single field uniform dose optimization comes at an increased radiation exposure of normal tissues, e.g. ≈2 Gy (RBE) in the mean dose in the kidneys compared to conventional and worst case optimization and ≈4 Gy (RBE) in D 1 in the spinal cord compared to worst case optimization. Interfractional motion substantially deteriorates dose distributions for carbon ion treatments of pancreatic cancer patients. Single field uniform dose optimization mitigates the negative influence of motion on target coverage at an increased radiation exposure of normal tissue. Worst case optimization enables an exploration of the trade-off between robust target coverage and organ at risk sparing during inverse treatment planning beyond margin concepts.
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DOI：
10.1016/j.ijrobp.2008.10.055
发表时间：
2009-03-15
影响因子：
7
作者：
Kumagai, Motoki;Hara, Ryusuke;Kamada, Tadashi
通讯作者：
Kamada, Tadashi
DOI：
10.1186/s13014-015-0538-x
发表时间：
2015-11-21
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Dreher C;Habermehl D;Ecker S;Brons S;El-Shafie R;Jäkel O;Debus J;Combs SE
通讯作者：
Combs SE
DOI：
10.1097/01.coc.0000046037.75545.ad
发表时间：
2004-02-01
影响因子：
2.6
作者：
Matsui, Y;Asano, T;Ochiai, T
通讯作者：
Ochiai, T
DOI：
10.1016/j.ijrobp.2009.06.029
发表时间：
2010-02-01
影响因子：
7
作者：
Jayachandran, Priya;Minn, A. Yuriko;Chang, Daniel T.
通讯作者：
Chang, Daniel T.
呼吸运动对肺癌的最坏情况优化强度调制质子治疗的影响。
影响因子：
3.3
作者：
Liu W;Liao Z;Schild SE;Liu Z;Li H;Li Y;Park PC;Li X;Stoker J;Shen J;Keole S;Anand A;Fatyga M;Dong L;Sahoo N;Vora S;Wong W;Zhu XR;Bues M;Mohan R
通讯作者：
Mohan R