Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy
PurposeThe goal of this study is to investigate treatment planning of total marrow irradiation (TMI) using intensity-modulated spot-scanning proton therapy (IMPT). The dosimetric parameters of the intensity-modulated proton plans were evaluated and compared with the corresponding TMI plans generated...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.955004/full |
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| author | Darren M. Zuro Gabriel Vidal James Nathan Cantrell Yong Chen Chunhui Han Christina Henson Salahuddin Ahmad Susanta Hui Imad Ali |
| author_facet | Darren M. Zuro Gabriel Vidal James Nathan Cantrell Yong Chen Chunhui Han Christina Henson Salahuddin Ahmad Susanta Hui Imad Ali |
| author_sort | Darren M. Zuro |
| collection | DOAJ |
| description | PurposeThe goal of this study is to investigate treatment planning of total marrow irradiation (TMI) using intensity-modulated spot-scanning proton therapy (IMPT). The dosimetric parameters of the intensity-modulated proton plans were evaluated and compared with the corresponding TMI plans generated with volumetric modulated arc therapy (VMAT) using photon beams.MethodsIntensity-modulated proton plans for TMI were created using the Monte Carlo dose-calculation algorithm in the Raystation 11A treatment planning system with spot-scanning proton beams from the MEVION S250i Hyperscan system. Treatment plans were generated with four isocenters placed along the longitudinal direction, each with a set of five beams for a total of 20 beams. VMAT-TMI plans were generated with the Eclipse-V15 analytical anisotropic algorithm (AAA) using a Varian Trilogy machine. Three planning target volumes (PTVs) for the bones, ribs, and spleen were covered by 12 Gy. The dose conformity index, D80, D50, and D10, for PTVs and organs at risk (OARs) for the IMPT plans were quantified and compared with the corresponding VMAT plans.ResultsThe mean dose for most of the OARs was reduced substantially (5% and more) in the IMPT plans for TMI in comparison with VMAT plans except for the esophagus and thyroid, which experienced an increase in dose. This dose reduction is due to the fast dose falloff of the distal Bragg peak in the proton plans. The conformity index was found to be similar (0.78 vs 0.75) for the photon and proton plans. IMPT plans provided superior superficial dose coverage for the skull and ribs in comparison with VMAT because of increased entrance dose deposition by the proton beams.ConclusionTreatment plans for TMI generated with IMPT were superior to VMAT plans mainly due to a large reduction in the OAR dose. Although the current IMPT-TMI technique is not clinically practical due to the long overall treatment time, this study presents an enticing alternative to conventional TMI with photons by providing superior dose coverage of the targets, increased sparing of the OARs, and enhanced radiobiological effects associated with proton therapy. |
| first_indexed | 2024-12-11T16:22:29Z |
| format | Article |
| id | doaj.art-f5792545ea7a41e8b32f800d40f6deca |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-11T16:22:29Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-f5792545ea7a41e8b32f800d40f6deca2022-12-22T00:58:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-07-011210.3389/fonc.2022.955004955004Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapyDarren M. Zuro0Gabriel Vidal1James Nathan Cantrell2Yong Chen3Chunhui Han4Christina Henson5Salahuddin Ahmad6Susanta Hui7Imad Ali8Department of Radiation Oncology, University of Oklahoma Health Science Center (HSC), Oklahoma City, OK, United StatesDepartment of Radiation Oncology, University of Oklahoma Health Science Center (HSC), Oklahoma City, OK, United StatesDepartment of Radiation Oncology, University of Oklahoma Health Science Center (HSC), Oklahoma City, OK, United StatesDepartment of Radiation Oncology, University of Oklahoma Health Science Center (HSC), Oklahoma City, OK, United StatesDepartment of Radiation Oncology, City of Hope, Durate, CA, United StatesDepartment of Radiation Oncology, University of Oklahoma Health Science Center (HSC), Oklahoma City, OK, United StatesDepartment of Radiation Oncology, University of Oklahoma Health Science Center (HSC), Oklahoma City, OK, United StatesDepartment of Radiation Oncology, City of Hope, Durate, CA, United StatesDepartment of Radiation Oncology, University of Oklahoma Health Science Center (HSC), Oklahoma City, OK, United StatesPurposeThe goal of this study is to investigate treatment planning of total marrow irradiation (TMI) using intensity-modulated spot-scanning proton therapy (IMPT). The dosimetric parameters of the intensity-modulated proton plans were evaluated and compared with the corresponding TMI plans generated with volumetric modulated arc therapy (VMAT) using photon beams.MethodsIntensity-modulated proton plans for TMI were created using the Monte Carlo dose-calculation algorithm in the Raystation 11A treatment planning system with spot-scanning proton beams from the MEVION S250i Hyperscan system. Treatment plans were generated with four isocenters placed along the longitudinal direction, each with a set of five beams for a total of 20 beams. VMAT-TMI plans were generated with the Eclipse-V15 analytical anisotropic algorithm (AAA) using a Varian Trilogy machine. Three planning target volumes (PTVs) for the bones, ribs, and spleen were covered by 12 Gy. The dose conformity index, D80, D50, and D10, for PTVs and organs at risk (OARs) for the IMPT plans were quantified and compared with the corresponding VMAT plans.ResultsThe mean dose for most of the OARs was reduced substantially (5% and more) in the IMPT plans for TMI in comparison with VMAT plans except for the esophagus and thyroid, which experienced an increase in dose. This dose reduction is due to the fast dose falloff of the distal Bragg peak in the proton plans. The conformity index was found to be similar (0.78 vs 0.75) for the photon and proton plans. IMPT plans provided superior superficial dose coverage for the skull and ribs in comparison with VMAT because of increased entrance dose deposition by the proton beams.ConclusionTreatment plans for TMI generated with IMPT were superior to VMAT plans mainly due to a large reduction in the OAR dose. Although the current IMPT-TMI technique is not clinically practical due to the long overall treatment time, this study presents an enticing alternative to conventional TMI with photons by providing superior dose coverage of the targets, increased sparing of the OARs, and enhanced radiobiological effects associated with proton therapy.https://www.frontiersin.org/articles/10.3389/fonc.2022.955004/fulltotal marrow irradiation (TMI)volumetric arc radiotherapyproton radiation therapydosimetric analysesradiation therapy |
| spellingShingle | Darren M. Zuro Gabriel Vidal James Nathan Cantrell Yong Chen Chunhui Han Christina Henson Salahuddin Ahmad Susanta Hui Imad Ali Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy Frontiers in Oncology total marrow irradiation (TMI) volumetric arc radiotherapy proton radiation therapy dosimetric analyses radiation therapy |
| title | Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy |
| title_full | Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy |
| title_fullStr | Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy |
| title_full_unstemmed | Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy |
| title_short | Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy |
| title_sort | treatment planning of total marrow irradiation with intensity modulated spot scanning proton therapy |
| topic | total marrow irradiation (TMI) volumetric arc radiotherapy proton radiation therapy dosimetric analyses radiation therapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.955004/full |
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