Technical Note: Multiple energy extraction techniques for synchrotron-based proton delivery systems may exacerbate motion interplay effects in lung cancer treatments.
interplay effect
motion
multiple energy extraction
proton therapy
Journal
Medical physics
ISSN: 2473-4209
Titre abrégé: Med Phys
Pays: United States
ID NLM: 0425746
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
revised:
12
03
2021
received:
04
09
2020
accepted:
09
06
2021
pubmed:
27
6
2021
medline:
23
9
2021
entrez:
26
6
2021
Statut:
ppublish
Résumé
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 intrafractional 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 nonrandomly 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 four-dimensional (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 D 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.
Identifiants
pubmed: 34174087
doi: 10.1002/mp.15056
pmc: PMC8455432
mid: NIHMS1719152
doi:
Substances chimiques
Protons
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4812-4823Subventions
Organisme : NCI NIH HHS
ID : K25 CA168984
Pays : United States
Organisme : Arizona Biomedical Research Commission
Organisme : Lawrence W. and Marilyn W. Matteson Fund for Cancer Research
Organisme : NCI NIH HHS
ID : K25CA168984
Pays : United States
Organisme : Kemper Marley Foundation
Informations de copyright
© 2021 American Association of Physicists in Medicine.
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