SDDRO-joint: simultaneous dose and dose rate optimization with the joint use of transmission beams and Bragg peaks for FLASH proton therapy.
SDDRO-joint: simultaneous dose and dose rate optimization with the joint use of transmission beams and Bragg peaks for FLASH proton therapy.
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DOI：
10.1088/1361-6560/ac02d8
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发表时间：
2021-06-14
影响因子：
3.5
通讯作者：
中科院分区：
文献类型：
--
作者：
采用超高剂量率照射的肿瘤放射治疗（RT），即FLASH-RT，可以在维持肿瘤反应的同时，显著降低辐射诱导的正常组织毒性。目前，对深部肿瘤的临床FLASH-RT只能用质子束进行。在深度实现超高剂量率的一种方法是通过使用高能透射束（TB），其中布拉格峰落在体外。然而，单独使用TB的计划并不能像传统的强度调制质子治疗（IMPT）那样完全利用剂量成形的自由度，IMPT在肿瘤靶点处使用多能量质子束的布拉格峰（BP）。本工作将开发一种联合使用TB和BP的同时剂量率优化（SDDRO）方法，即SDDRO-Joint。具体而言，BP被放置在肿瘤靶内以改善靶剂量适形性并稀疏正常组织剂量，而TB主要覆盖肿瘤边界以实现接近肿瘤靶的危险器官（OAR）的超高剂量率覆盖。通过SDDRO-关节的OAR和其他正常组织的保留是由TB和BP联合进行的，即，TB节省FLASH和BP节省剂量。结果表明，BP的加入大大增加了SDDRO的目标剂量符合性。值得注意的是，SDDRO-Joint的适形指数值也略高于仅使用BP的常规调强质子治疗（IMPT）方法。
Cancer radiotherapy (RT) with the irradiation at ultra-high dose rates, namely FLASH-RT, can substantially reduce radiation-induced normal tissue toxicities while maintaining tumor response. Currently, clinical FLASH-RT on deep-seated tumors can only be performed with proton beams. One way to achieve ultra-high dose rates at depth is through the use of high-energy transmission beams (TB), where the Bragg peaks fall outside the body. However, planning with TB alone does not fully leverage the degrees of freedom for dose shaping as traditional intensity modulated proton therapy (IMPT) which uses the Bragg peaks (BP) of multi-energy proton beams at the tumor target. This work will develop a simultaneous dose and dose rate optimization (SDDRO) method with the joint use of TB and BP, namely SDDRO-Joint. Specifically, BP are placed inside tumor targets to improve the target dose conformality and sparse the normal-tissue dose, while TB primarily cover the tumor boundary to achieve ultra-high dose rate coverage of organs-at-risk (OAR) close to tumor targets. The sparing of OAR and other normal tissues via SDDRO-Joint is jointly by TB and BP, i.e., the FLASH sparing by TB and the dose sparing by BP. The results suggest that the addition of BP substantially increased the target dose conformality for SDDRO. Noticeably SDDRO-Joint also provided slightly higher conformal index values than the conventional intensity modulated proton therapy (IMPT) method with BP alone.
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影响因子：
3.8
作者：
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通讯作者：
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影响因子：
5.7
作者：
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Vozenin, Marie-Catherine
影响因子：
5.7
作者：
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通讯作者：
Vozenin, Marie-Catherine
影响因子：
3.8
作者：
Gu W;O'Connor D;Nguyen D;Yu VY;Ruan D;Dong L;Sheng K
通讯作者：
Sheng K
DOI：
10.1073/pnas.1901777116
发表时间：
2019-05-28
影响因子：
11.1
作者：
Montay-Gruel, Pierre;Acharya, Munjal M.;Limoli, Charles L.
通讯作者：
Limoli, Charles L.