Spot-Scanning Proton Arc (SPArc) Therapy: The First Robust and Delivery-Efficient Spot-Scanning Proton Arc Therapy
Spot-Scanning Proton Arc (SPArc) Therapy: The First Robust and Delivery-Efficient Spot-Scanning Proton Arc Therapy
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DOI：
10.1016/j.ijrobp.2016.08.049
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发表时间：
2016-12-01
影响因子：
7
通讯作者：
Yan, Di
中科院分区：
文献类型：
--
作者：
Ding, Xuanfeng;Li, Xiaoqiang;Yan, Di
目的：为了提出一种新的强大的和交付高效的点扫描质子弧（SPArc）治疗technology.Methods和Materials：SPArc的优化算法，集成控制点resstriking，能量层重新分布，能量层过滤，能量层resstriking。这种技术的可行性进行了评估，使用样本患者：1例局部晚期头颈口咽癌与双侧淋巴结覆盖，1例与非移动肺癌。将计划质量、稳健性和总估计输送时间与稳健优化的多场分步发射弧形计划（无SPArc优化）（Arcmulti-field）和标准稳健优化的调强质子治疗（IMPT）计划进行了比较。考虑到设置和范围的不确定性，分析了靶和危险器官的剂量-体积直方图。总输送时间计算的基础上，360度机架室1转每分钟机架旋转速度，2毫秒的点切换时间，1-nA的束流，0.01最小点监视器单元，和能量层切换时间为0.5至4 second.Results：SPArc计划显示出潜在的剂量优势，为两个临床样本的情况。与IMPT相比，SPArc对口咽癌和肺癌病例的积分剂量分别减少8%和14%。此外，与IMPT相比，评估肺癌计划，很明显，最大皮肤剂量，平均肺剂量和肋骨最大剂量分别减少了60%，15%和35%，而符合性指数从7.6（IMPT）提高到4.0（SPArc）。肺癌和口咽癌患者的总治疗交付时间分别减少了55%至60%和56%至67%，当与ARC多场plannes.Conclusion相比：SPArc计划是第一个强大的和交付效率高的质子点扫描弧治疗技术，这可能会被实施到常规的临床实践。(C)2016 Elsevier Inc. All rights reserved.
Purpose: To present a novel robust and delivery-efficient spot-scanning proton arc (SPArc) therapy technique.Methods and Materials: A SPArc optimization algorithm was developed that integrates control point resampling, energy layer redistribution, energy layer filtration, and energy layer resampling. The feasibility of such a technique was evaluated using sample patients: 1 patient with locally advanced head and neck oropharyngeal cancer with bilateral lymph node coverage, and 1 with a nonmobile lung cancer. Plan quality, robustness, and total estimated delivery time were compared with the robust optimized multifield step-and-shoot arc plan without SPArc optimization (Arcmulti-field) and the standard robust optimized intensity modulated proton therapy (IMPT) plan. Dose-volume histograms of target and organs at risk were analyzed, taking into account the setup and range uncertainties. Total delivery time was calculated on the basis of a 360 degrees gantry room with 1 revolutions per minute gantry rotation speed, 2-millisecond spot switching time, 1-nA beam current, 0.01 minimum spot monitor unit, and energy layer switching time of 0.5 to 4 seconds.Results: The SPArc plan showed potential dosimetric advantages for both clinical sample cases. Compared with IMPT, SPArc delivered 8% and 14% less integral dose for oropharyngeal and lung cancer cases, respectively. Furthermore, evaluating the lung cancer plan compared with IMPT, it was evident that the maximum skin dose, the mean lung dose, and the maximum dose to ribs were reduced by 60%, 15%, and 35%, respectively, whereas the conformity index was improved from 7.6 (IMPT) to 4.0 (SPArc). The total treatment delivery time for lung and oropharyngeal cancer patients was reduced by 55% to 60% and 56% to 67%, respectively, when compared with Arcmulti-field plans.Conclusion: The SPArc plan is the first robust and delivery-efficient proton spot-scanning arc therapy technique, which could potentially be implemented into routine clinical practice. (C) 2016 Elsevier Inc. All rights reserved.