Assessment of IMPT versus VMAT plans using different uncertainty scenarios for prostate cancer
Abstract Background To assess the impact of systematic setup and range uncertainties for robustly optimized (RO) intensity modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) plans in patients with localized prostate cancer. Methods Twenty-six localized prostate patients prev...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-022-02126-y |
| _version_ | 1811200661454323712 |
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| author | Michael P. Butkus Nellie Brovold Tejan Diwanji Yihang Xu Mariluz De Ornelas Alan Dal Pra Matt Abramowitz Alan Pollack Nesrin Dogan |
| author_facet | Michael P. Butkus Nellie Brovold Tejan Diwanji Yihang Xu Mariluz De Ornelas Alan Dal Pra Matt Abramowitz Alan Pollack Nesrin Dogan |
| author_sort | Michael P. Butkus |
| collection | DOAJ |
| description | Abstract Background To assess the impact of systematic setup and range uncertainties for robustly optimized (RO) intensity modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) plans in patients with localized prostate cancer. Methods Twenty-six localized prostate patients previously treated with VMAT (CTV to PTV expansion of 3-5 mm) were re-planned with RO-IMPT with 3 mm and 5 mm geometrical uncertainties coupled with 3% range uncertainties. Robust evaluations (RE) accounting for the geometrical uncertainties of 3 and 5 mm were evaluated for the IMPT and VMAT plans. Clinical target volume (CTV), anorectum, and bladder dose metrics were analyzed between the nominal plans and their uncertainty perturbations. Results With geometric uncertainties of 5 mm and accounting for potential inter-fractional perturbations, RO-IMPT provided statistically significant (p < 0.05) sparing at intermediate doses (V4000cGy) to the anorectum and bladder and high dose sparring (V8000cGy) to the bladder compared to VMAT. Decreasing the RO and RE parameters to 3 mm improved IMPT sparing over VMAT at all OAR dose levels investigated while maintaining equivalent coverage to the CTV. Conclusions For localized prostate treatments, if geometric uncertainties can be maintained at or below 3 mm, RO-IMPT provides clear dosimetric advantages in anorectum and bladder sparing compared to VMAT. This advantage remains even under uncertainty scenarios. As geometric uncertainties increase to 5 mm, RO-IMPT still provides dosimetric advantages, but to a smaller magnitude. |
| first_indexed | 2024-04-12T02:08:30Z |
| format | Article |
| id | doaj.art-f1747c172f4e4e8d80407c609438fadf |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-04-12T02:08:30Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-f1747c172f4e4e8d80407c609438fadf2022-12-22T03:52:29ZengBMCRadiation Oncology1748-717X2022-09-0117111210.1186/s13014-022-02126-yAssessment of IMPT versus VMAT plans using different uncertainty scenarios for prostate cancerMichael P. Butkus0Nellie Brovold1Tejan Diwanji2Yihang Xu3Mariluz De Ornelas4Alan Dal Pra5Matt Abramowitz6Alan Pollack7Nesrin Dogan8Department of Radiation Oncology, University of Miami Miller School of MedicineDepartment of Radiation Oncology, University of Miami Miller School of MedicineDepartment of Radiation Oncology, University of Miami Miller School of MedicineDepartment of Radiation Oncology, University of Miami Miller School of MedicineDepartment of Radiation Oncology, University of Miami Miller School of MedicineDepartment of Radiation Oncology, University of Miami Miller School of MedicineDepartment of Radiation Oncology, University of Miami Miller School of MedicineDepartment of Radiation Oncology, University of Miami Miller School of MedicineDepartment of Radiation Oncology, University of Miami Miller School of MedicineAbstract Background To assess the impact of systematic setup and range uncertainties for robustly optimized (RO) intensity modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) plans in patients with localized prostate cancer. Methods Twenty-six localized prostate patients previously treated with VMAT (CTV to PTV expansion of 3-5 mm) were re-planned with RO-IMPT with 3 mm and 5 mm geometrical uncertainties coupled with 3% range uncertainties. Robust evaluations (RE) accounting for the geometrical uncertainties of 3 and 5 mm were evaluated for the IMPT and VMAT plans. Clinical target volume (CTV), anorectum, and bladder dose metrics were analyzed between the nominal plans and their uncertainty perturbations. Results With geometric uncertainties of 5 mm and accounting for potential inter-fractional perturbations, RO-IMPT provided statistically significant (p < 0.05) sparing at intermediate doses (V4000cGy) to the anorectum and bladder and high dose sparring (V8000cGy) to the bladder compared to VMAT. Decreasing the RO and RE parameters to 3 mm improved IMPT sparing over VMAT at all OAR dose levels investigated while maintaining equivalent coverage to the CTV. Conclusions For localized prostate treatments, if geometric uncertainties can be maintained at or below 3 mm, RO-IMPT provides clear dosimetric advantages in anorectum and bladder sparing compared to VMAT. This advantage remains even under uncertainty scenarios. As geometric uncertainties increase to 5 mm, RO-IMPT still provides dosimetric advantages, but to a smaller magnitude.https://doi.org/10.1186/s13014-022-02126-yIMPTRobust optimizationProstate cancer |
| spellingShingle | Michael P. Butkus Nellie Brovold Tejan Diwanji Yihang Xu Mariluz De Ornelas Alan Dal Pra Matt Abramowitz Alan Pollack Nesrin Dogan Assessment of IMPT versus VMAT plans using different uncertainty scenarios for prostate cancer Radiation Oncology IMPT Robust optimization Prostate cancer |
| title | Assessment of IMPT versus VMAT plans using different uncertainty scenarios for prostate cancer |
| title_full | Assessment of IMPT versus VMAT plans using different uncertainty scenarios for prostate cancer |
| title_fullStr | Assessment of IMPT versus VMAT plans using different uncertainty scenarios for prostate cancer |
| title_full_unstemmed | Assessment of IMPT versus VMAT plans using different uncertainty scenarios for prostate cancer |
| title_short | Assessment of IMPT versus VMAT plans using different uncertainty scenarios for prostate cancer |
| title_sort | assessment of impt versus vmat plans using different uncertainty scenarios for prostate cancer |
| topic | IMPT Robust optimization Prostate cancer |
| url | https://doi.org/10.1186/s13014-022-02126-y |
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