Technical Note: Multiple energy extraction techniques for synchrotron-based proton delivery systems may exacerbate motion interplay effects in lung cancer treatments.
Technical Note: Multiple energy extraction techniques for synchrotron-based proton delivery systems may exacerbate motion interplay effects in lung cancer treatments.
复制标题
技术说明：基于同步加速器的质子输送系统的多种能量提取技术可能会加剧肺癌治疗中的运动相互作用效应。
DOI：
10.1002/mp.15056
复制
发表时间：
2021-09
期刊：
影响因子：
3.8
通讯作者：
Liu W
中科院分区：
文献类型：
--
作者：
Younkin JE;Morales DH;Shen J;Ding X;Stoker JB;Yu NY;Sio TT;Daniels TB;Bues M;Fatyga M;Schild SE;Liu W
用于基于同步加速器的质子输送系统的多能量提取（multiple energy extraction，简称EEE）输送技术通过在一次加速器溢出期间多次减速射束来减少射束输送时间，但是这可能由于分次内运动而导致额外的计划质量降级。我们试图确定，由于相互作用的影响，与用于肺癌治疗的单能量提取（SEE）相比，双能量提取是否会导致显著不同的计划质量下降。根据肿瘤运动幅度、肿瘤体积和呼吸周期的代表性范围，对10例在我们机构接受IMPT治疗的肺癌患者进行非随机抽样。使用Wilcoxon符号秩检验比较单次SEE和DVH 4D动态剂量分布的剂量体积直方图（DVH）指数。监测单位（MU）的呼吸阶段的分布进行了调查的功能与计划质量下降。在最差情况患者治疗方案的分次分娩中，比较SEE和EPWDVH指数，以评价分次分娩的影响。在单次给药中，SEE和SERT之间的目标平均剂量、目标剂量一致性或危及器官的剂量无临床显著差异。与SEE相比，3例患者的剂量均匀性显著更差（单次平均D5%-D95%增加至处方剂量的9.6%），MU分布至呼吸相位的曲线显示了与SEE同步的模式，但与SEE无关。然而，在30次分割后，最差情况下的患者具有临床可接受的靶剂量均匀性和剂量分布覆盖率（与SEE相比，平均D5%-D95%增加1%）。对于一些呼吸周期接近平均溢出持续时间的患者，由于相互作用效应，与SEE相比，EAE导致单次剂量靶剂量均匀性显著更差。然而，通过分次治疗缓解了这一问题，并且在30次分次治疗后，靶剂量均匀性和覆盖范围在临床上是可接受的。
The multiple energy extraction (MEE) delivery technique for synchrotron-based proton delivery systems reduces beam delivery time by decelerating the beam multiple times during one accelerator spill, but this might cause additional plan quality degradation due to intra-fractional motion. We seek to determine whether MEE causes significantly different plan quality degradation compared to single energy extraction (SEE) for lung cancer treatments due to the interplay effect. Ten lung cancer patients treated with IMPT at our institution were non-randomly sampled based on a representative range of tumor motion amplitudes, tumor volumes, and respiratory periods. Dose-volume histogram (DVH) indices from single-fraction SEE and MEE 4D dynamic dose distributions were compared using the Wilcoxon signed-rank test. Distributions of monitor units (MU) to breathing phases were investigated for features associated with plan quality degradation. SEE and MEE DVH indices were compared in fractionated deliveries of the worst-case patient treatment scenario to evaluate the impact of fractionation. There were no clinically significant differences in target mean dose, target dose conformity, or dose to organs-at-risk between SEE and MEE in single-fraction delivery. Three patients had significantly worse dose homogeneity with MEE compared to SEE (single-fraction mean D5%–D95% increased by up to 9.6% of prescription dose), and plots of MU distribution to breathing phases showed synchronization patterns with MEE but not SEE. However, after 30 fractions the patient in the worst-case scenario had clinically-acceptable target dose homogeneity and coverage with MEE (mean D5%–D95% increased by 1% compared to SEE). For some patients with breathing periods close to the mean spill duration, MEE resulted in significantly worse single-fraction target dose homogeneity compared to SEE due to the interplay effect. However, this was mitigated by fractionation, and target dose homogeneity and coverage were clinically acceptable after 30 fractions with MEE.
登录
查看更多内容
肺癌调强质子治疗中 4D 与 3D 稳健优化的探索性研究。
DOI：
10.1016/j.ijrobp.2015.11.002
发表时间：
2016-05-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Liu W;Schild SE;Chang JY;Liao Z;Chang YH;Wen Z;Shen J;Stoker JB;Ding X;Hu Y;Sahoo N;Herman MG;Vargas C;Keole S;Wong W;Bues M
通讯作者：
Bues M
影响因子：
3.8
作者：
Li, Heng;Li, Yupeng;Zhu, X. Ronald
通讯作者：
Zhu, X. Ronald
影响因子：
3.5
作者：
Chan, TCY;Bortfeld, T;Tsitsiklis, JN
通讯作者：
Tsitsiklis, JN
DOI：
10.1016/j.ijrobp.2018.02.009
发表时间：
2018-06-01
影响因子：
7
作者：
Liu, Chenbin;Schild, Steven E.;Liu, Wei
通讯作者：
Liu, Wei
影响因子：
3.8
作者：
Liu, Chenbin;Yu, Nathan Y.;Liu, Wei
通讯作者：
Liu, Wei