Comparison of weekly and daily online adaptation for head and neck intensity-modulated proton therapy.
Comparison of weekly and daily online adaptation for head and neck intensity-modulated proton therapy.
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DOI：
10.1088/1361-6560/abe050
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发表时间：
2021-02-25
影响因子：
3.5
通讯作者：
Paganetti H
中科院分区：
文献类型：
--
作者：
Bobić M;Lalonde A;Sharp GC;Grassberger C;Verburg JM;Winey BA;Lomax AJ;Paganetti H
强度调制质子治疗（IMPT）剂量分布的高度适形性导致治疗计划对分次治疗过程中的几何变化敏感。这可以通过适应性质子治疗（APT）来解决。APT中的一个重要问题是在分次治疗期间进行调整的频率，这与计划调整是否必须在线或离线完成的问题有关。本研究的目的是调查每周和每日在线IMPT计划调整对头颈部患者治疗质量的影响。回顾性评价了10名头颈部患者的队列，这些患者每天都获得锥形束CT（CBCT）图像。在三种情况下进行了IMPT治疗的剂量跟踪：无调整的基础计划（BP）、每周在线调整（OAW）和每日在线调整（OAD）。两种适应方案均使用内部开发的在线APT工作流程，对散射校正CBCT进行蒙特卡罗（MC）剂量计算。IMPT计划自适应仅通过调整子束子集的权重来实现，基于从计划CT到每个CBCT的可变形图像配准。虽然OAD缓解随机输送错误比OAW更有效，但OAW和OAD均达到了所有10例患者的临床目标，而BP在6例病例中失败。在高危CTV中，D98%的累积值范围为OAD处方剂量的97.15%-99.73%，中位数为98.07%。对于OAW，获得的值在95.02%和99.26%之间，中位数为处方剂量的97.61%。除此之外，所有三种情况下大多数危及器官的剂量相似。在全球范围内，我们的研究结果表明，OAW可以作为OAD的替代方法，用于大多数患者，以减少临床工作量。
The high conformality of intensity-modulated proton therapy (IMPT) dose distributions causes treatment plans to be sensitive to geometrical changes during the course of a fractionated treatment. This can be addressed using adaptive proton therapy (APT). One important question in APT is the frequency of adaptations performed during a fractionated treatment, which is related to the question whether plan adaptation has to be done online or offline. The purpose of this work is to investigate the impact of weekly and daily online IMPT plan adaptation on the treatment quality for head and neck patients. A cohort of ten head and neck patients with daily acquired cone-beam CT (CBCT) images was evaluated retrospectively. Dose tracking of the IMPT treatment was performed for three scenarios: base plan with no adaptation (BP), weekly online adaptation (OAW), and daily online adaptation (OAD). Both adaptation schemes used an in-house developed online APT workflow, performing Monte Carlo (MC) dose calculations on scatter-corrected CBCTs. IMPT plan adaptation was achieved by only tuning the weights of a subset of beamlets, based on deformable image registration from the planning CT to each CBCT. Although OAD mitigated random delivery errors more effectively than OAW on a fraction per fraction basis, both OAW and OAD achieved the clinical goals for all ten patients, while BP failed for six cases. In the high-risk CTV, accumulated values of D98% ranged between 97.15% and 99.73% of the prescription dose for OAD, with a median of 98.07%. For OAW, values between 95.02% and 99.26% were obtained, with a median of 97.61% of the prescription dose. Otherwise, the dose to most organs at risk was similar for all three scenarios. Globally, our results suggest that OAW could be used as an alternative approach to OAD for most patients in order to reduce the clinical workload.
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DOI：
10.1016/j.ijrobp.2014.02.023
发表时间：
2014-06-01
影响因子：
7
作者：
Grassberger, Clemens;Daartz, Juliane;Dowdell, Stephen;Ruggieri, Thomas;Sharp, Greg;Paganetti, Harald
通讯作者：
Paganetti, Harald
DOI：
10.1186/s13014-016-0641-7
发表时间：
2016-04-30
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Kurz C;Nijhuis R;Reiner M;Ganswindt U;Thieke C;Belka C;Parodi K;Landry G
通讯作者：
Landry G
影响因子：
3.5
作者：
Jia, Xun;Gu, Xuejun;Jiang, Steve B.
通讯作者：
Jiang, Steve B.
影响因子：
3.5
作者：
Lomax, A. J.
通讯作者：
Lomax, A. J.
影响因子：
3.5
作者：
Kurz, Christopher;Maspero, Matteo;van den Berg, Cornelis A. T.
通讯作者：
van den Berg, Cornelis A. T.