Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy
Abstract Background This study investigated the feasibility and potential clinical benefit of utilizing a new proton treatment technique: Spot-scanning proton arc (SPArc) therapy for left-sided whole breast radiotherapy (WBRT) to further reduce radiation dose to healthy tissue and mitigate the proba...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-020-01676-3 |
| _version_ | 1818278688609796096 |
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| author | Sheng Chang Gang Liu Lewei Zhao Joshua T. Dilworth Weili Zheng Saada Jawad Di Yan Peter Chen Craig Stevens Peyman Kabolizadeh Xiaoqiang Li Xuanfeng Ding |
| author_facet | Sheng Chang Gang Liu Lewei Zhao Joshua T. Dilworth Weili Zheng Saada Jawad Di Yan Peter Chen Craig Stevens Peyman Kabolizadeh Xiaoqiang Li Xuanfeng Ding |
| author_sort | Sheng Chang |
| collection | DOAJ |
| description | Abstract Background This study investigated the feasibility and potential clinical benefit of utilizing a new proton treatment technique: Spot-scanning proton arc (SPArc) therapy for left-sided whole breast radiotherapy (WBRT) to further reduce radiation dose to healthy tissue and mitigate the probability of normal tissue complications compared to conventional intensity modulated proton therapy (IMPT). Methods Eight patients diagnosed with left-sided breast cancer and treated with breast-preserving surgery followed by whole breast irradiation without regional nodal irradiation were included in this retrospective planning. Two proton treatment plans were generated for each patient: vertical intensity-modulated proton therapy used for clinical treatment (vIMPT, gantry angle 10°–30°) and SPArc for comparison purpose. Both SPArc and vIMPT plans were optimized using the robust optimization of ± 3.5% range and 5 mm setup uncertainties. Root-mean-square deviation dose (RMSD) volume histograms were used for plan robustness evaluation. All dosimetric results were evaluated based on dose-volume histograms (DVH), and the interplay effect was evaluated based on the accumulation of single-fraction 4D dynamic dose on CT50. The treatment beam delivery time was simulated based on a gantry rotation with energy-layer-switching-time (ELST) from 0.2 to 5 s. Results The average D1 to the heart and LAD were reduced to 53.63 cGy and 82.25 cGy compared with vIMPT 110.38 cGy (p = 0.001) and 170.38 cGy (p = 0.001), respectively. The average V5Gy and V20Gy of ipsilateral lung was reduced to 16.77% and 3.07% compared to vIMPT 25.56% (p = 0.001) and 4.68% (p = 0.003). Skin3mm mean and maximum dose were reduced to 3999.38 cGy and 4395.63 cGy compared to vIMPT 4104.25 cGy (p = 0.039) and 4411.63 cGy (p = 0.043), respectively. A significant relative risk reduction (RNTCP = NTCPSPArc/NTCPvIMPT) for organs at risk (OARs) was obtained with SPArc ranging from 0.61 to 0.86 depending on the clinical endpoint. The RMSD volume histogram (RVH) analysis shows SPArc provided better plan robustness in OARs sparing, including the heart, LAD, ipsilateral lung, and skin. The average estimated treatment beam delivery times were comparable to vIMPT plans when the ELST is about 0.5 s. Conclusion SPArc technique can further reduce dose delivered to OARs and the probability of normal tissue complications in patients treated for left-sided WBRT. |
| first_indexed | 2024-12-12T23:21:25Z |
| format | Article |
| id | doaj.art-5e252d31e85248fbb98d9f556bf1a4d1 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-12T23:21:25Z |
| publishDate | 2020-10-01 |
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| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-5e252d31e85248fbb98d9f556bf1a4d12022-12-22T00:08:16ZengBMCRadiation Oncology1748-717X2020-10-0115111110.1186/s13014-020-01676-3Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapySheng Chang0Gang Liu1Lewei Zhao2Joshua T. Dilworth3Weili Zheng4Saada Jawad5Di Yan6Peter Chen7Craig Stevens8Peyman Kabolizadeh9Xiaoqiang Li10Xuanfeng Ding11Department of Radiation Oncology, Renmin Hospital, Wuhan UniversityDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemDepartment of Radiation Oncology, Beaumont Health SystemAbstract Background This study investigated the feasibility and potential clinical benefit of utilizing a new proton treatment technique: Spot-scanning proton arc (SPArc) therapy for left-sided whole breast radiotherapy (WBRT) to further reduce radiation dose to healthy tissue and mitigate the probability of normal tissue complications compared to conventional intensity modulated proton therapy (IMPT). Methods Eight patients diagnosed with left-sided breast cancer and treated with breast-preserving surgery followed by whole breast irradiation without regional nodal irradiation were included in this retrospective planning. Two proton treatment plans were generated for each patient: vertical intensity-modulated proton therapy used for clinical treatment (vIMPT, gantry angle 10°–30°) and SPArc for comparison purpose. Both SPArc and vIMPT plans were optimized using the robust optimization of ± 3.5% range and 5 mm setup uncertainties. Root-mean-square deviation dose (RMSD) volume histograms were used for plan robustness evaluation. All dosimetric results were evaluated based on dose-volume histograms (DVH), and the interplay effect was evaluated based on the accumulation of single-fraction 4D dynamic dose on CT50. The treatment beam delivery time was simulated based on a gantry rotation with energy-layer-switching-time (ELST) from 0.2 to 5 s. Results The average D1 to the heart and LAD were reduced to 53.63 cGy and 82.25 cGy compared with vIMPT 110.38 cGy (p = 0.001) and 170.38 cGy (p = 0.001), respectively. The average V5Gy and V20Gy of ipsilateral lung was reduced to 16.77% and 3.07% compared to vIMPT 25.56% (p = 0.001) and 4.68% (p = 0.003). Skin3mm mean and maximum dose were reduced to 3999.38 cGy and 4395.63 cGy compared to vIMPT 4104.25 cGy (p = 0.039) and 4411.63 cGy (p = 0.043), respectively. A significant relative risk reduction (RNTCP = NTCPSPArc/NTCPvIMPT) for organs at risk (OARs) was obtained with SPArc ranging from 0.61 to 0.86 depending on the clinical endpoint. The RMSD volume histogram (RVH) analysis shows SPArc provided better plan robustness in OARs sparing, including the heart, LAD, ipsilateral lung, and skin. The average estimated treatment beam delivery times were comparable to vIMPT plans when the ELST is about 0.5 s. Conclusion SPArc technique can further reduce dose delivered to OARs and the probability of normal tissue complications in patients treated for left-sided WBRT.http://link.springer.com/article/10.1186/s13014-020-01676-3Spot scanningProton arcLeft-sided breast cancerRobust optimization |
| spellingShingle | Sheng Chang Gang Liu Lewei Zhao Joshua T. Dilworth Weili Zheng Saada Jawad Di Yan Peter Chen Craig Stevens Peyman Kabolizadeh Xiaoqiang Li Xuanfeng Ding Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy Radiation Oncology Spot scanning Proton arc Left-sided breast cancer Robust optimization |
| title | Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy |
| title_full | Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy |
| title_fullStr | Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy |
| title_full_unstemmed | Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy |
| title_short | Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy |
| title_sort | feasibility study spot scanning proton arc therapy sparc for left sided whole breast radiotherapy |
| topic | Spot scanning Proton arc Left-sided breast cancer Robust optimization |
| url | http://link.springer.com/article/10.1186/s13014-020-01676-3 |
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