Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy
Purpose: To compare spatially fractionated radiation therapy (GRID) treatment planning techniques using proton pencil-beam-scanning (PBS) and photon therapy. Materials and Methods: PBS and volumetric modulated arc therapy (VMAT) GRID plans were retrospectively generated for 5 patients with bulky tum...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | International Journal of Particle Therapy |
| Subjects: | |
| Online Access: | https://theijpt.org/doi/pdf/10.14338/IJPT-22-00028 |
| _version_ | 1827160056018239488 |
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| author | Aditya Halthore, MD Zachary Fellows, MSc Anh Tran, MSc Curtiland Deville Jr, MD Jean L. Wright, MD Jeffrey Meyer, MD Heng Li, PhD Khadija Sheikh, PhD |
| author_facet | Aditya Halthore, MD Zachary Fellows, MSc Anh Tran, MSc Curtiland Deville Jr, MD Jean L. Wright, MD Jeffrey Meyer, MD Heng Li, PhD Khadija Sheikh, PhD |
| author_sort | Aditya Halthore, MD |
| collection | DOAJ |
| description | Purpose: To compare spatially fractionated radiation therapy (GRID) treatment planning techniques using proton pencil-beam-scanning (PBS) and photon therapy.
Materials and Methods: PBS and volumetric modulated arc therapy (VMAT) GRID plans were retrospectively generated for 5 patients with bulky tumors. GRID targets were arranged along the long axis of the gross tumor, spaced 2 and 3 cm apart, and treated with a prescription of 18 Gy. PBS plans used 2- to 3-beam multiple-field optimization with robustness evaluation. Dosimetric parameters including peak-to-edge ratio (PEDR), ratio of dose to 90% of the valley to dose to 10% of the peak VPDR(D90/D10), and volume of normal tissue receiving at least 5 Gy (V5) and 10 Gy (V10) were calculated. The peak-to-valley dose ratio (PVDR), VPDR(D90/D10), and organ-at-risk doses were prospectively assessed in 2 patients undergoing PBS-GRID with pretreatment quality assurance computed tomography (QACT) scans.
Results: PBS and VMAT GRID plans were generated for 5 patients with bulky tumors. Gross tumor volume values ranged from 826 to 1468 cm3. Peak-to-edge ratio for PBS was higher than for VMAT for both spacing scenarios (2-cm spacing, P = .02; 3-cm spacing, P = .01). VPDR(D90/D10) for PBS was higher than for VMAT (2-cm spacing, P =.004; 3-cm spacing, P = .002). Normal tissue V5 was lower for PBS than for VMAT (2-cm spacing, P = .03; 3-cm spacing, P = .02). Normal tissue mean dose was lower with PBS than with VMAT (2-cm spacing, P = .03; 3-cm spacing, P = .02). Two patients treated using PBS GRID and assessed with pretreatment QACT scans demonstrated robust PVDR, VPDR(D90/D10), and organs-at-risk doses.
Conclusions: The PEDR was significantly higher for PBS than VMAT plans, indicating lower target edge dose. Normal tissue mean dose was significantly lower with PBS than VMAT. PBS GRID may result in lower normal tissue dose compared with VMAT plans, allowing for further dose escalation in patients with bulky disease. |
| first_indexed | 2024-04-10T19:12:04Z |
| format | Article |
| id | doaj.art-4fc8cd302d9c48f4be1319af00597fb1 |
| institution | Directory Open Access Journal |
| issn | 2331-5180 |
| language | English |
| last_indexed | 2025-03-21T00:06:57Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Particle Therapy |
| spelling | doaj.art-4fc8cd302d9c48f4be1319af00597fb12024-08-03T10:16:35ZengElsevierInternational Journal of Particle Therapy2331-51802022-12-01404910.14338/IJPT-22-00028i2331-5180-9-3-40Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID TherapyAditya Halthore, MD0Zachary Fellows, MSc1Anh Tran, MSc2Curtiland Deville Jr, MD3Jean L. Wright, MD4Jeffrey Meyer, MD5Heng Li, PhD6Khadija Sheikh, PhD71 Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA2 Department of Radiation Oncology, The Johns Hopkins Proton Center, Washington, DC, USA2 Department of Radiation Oncology, The Johns Hopkins Proton Center, Washington, DC, USA1 Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA1 Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA1 Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA1 Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA1 Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USAPurpose: To compare spatially fractionated radiation therapy (GRID) treatment planning techniques using proton pencil-beam-scanning (PBS) and photon therapy. Materials and Methods: PBS and volumetric modulated arc therapy (VMAT) GRID plans were retrospectively generated for 5 patients with bulky tumors. GRID targets were arranged along the long axis of the gross tumor, spaced 2 and 3 cm apart, and treated with a prescription of 18 Gy. PBS plans used 2- to 3-beam multiple-field optimization with robustness evaluation. Dosimetric parameters including peak-to-edge ratio (PEDR), ratio of dose to 90% of the valley to dose to 10% of the peak VPDR(D90/D10), and volume of normal tissue receiving at least 5 Gy (V5) and 10 Gy (V10) were calculated. The peak-to-valley dose ratio (PVDR), VPDR(D90/D10), and organ-at-risk doses were prospectively assessed in 2 patients undergoing PBS-GRID with pretreatment quality assurance computed tomography (QACT) scans. Results: PBS and VMAT GRID plans were generated for 5 patients with bulky tumors. Gross tumor volume values ranged from 826 to 1468 cm3. Peak-to-edge ratio for PBS was higher than for VMAT for both spacing scenarios (2-cm spacing, P = .02; 3-cm spacing, P = .01). VPDR(D90/D10) for PBS was higher than for VMAT (2-cm spacing, P =.004; 3-cm spacing, P = .002). Normal tissue V5 was lower for PBS than for VMAT (2-cm spacing, P = .03; 3-cm spacing, P = .02). Normal tissue mean dose was lower with PBS than with VMAT (2-cm spacing, P = .03; 3-cm spacing, P = .02). Two patients treated using PBS GRID and assessed with pretreatment QACT scans demonstrated robust PVDR, VPDR(D90/D10), and organs-at-risk doses. Conclusions: The PEDR was significantly higher for PBS than VMAT plans, indicating lower target edge dose. Normal tissue mean dose was significantly lower with PBS than VMAT. PBS GRID may result in lower normal tissue dose compared with VMAT plans, allowing for further dose escalation in patients with bulky disease.https://theijpt.org/doi/pdf/10.14338/IJPT-22-00028protonspatial fractionationgridbulky tumors |
| spellingShingle | Aditya Halthore, MD Zachary Fellows, MSc Anh Tran, MSc Curtiland Deville Jr, MD Jean L. Wright, MD Jeffrey Meyer, MD Heng Li, PhD Khadija Sheikh, PhD Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy International Journal of Particle Therapy proton spatial fractionation grid bulky tumors |
| title | Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy |
| title_full | Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy |
| title_fullStr | Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy |
| title_full_unstemmed | Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy |
| title_short | Treatment Planning of Bulky Tumors Using Pencil Beam Scanning Proton GRID Therapy |
| title_sort | treatment planning of bulky tumors using pencil beam scanning proton grid therapy |
| topic | proton spatial fractionation grid bulky tumors |
| url | https://theijpt.org/doi/pdf/10.14338/IJPT-22-00028 |
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