scholarly journals Robust intensity-modulated proton therapy to reduce high linear energy transfer in organs at risk

2017 ◽  
Vol 44 (12) ◽  
pp. 6138-6147 ◽  
Author(s):  
Yu An ◽  
Jie Shan ◽  
Samir H. Patel ◽  
William Wong ◽  
Steven E. Schild ◽  
...  
Keyword(s):  
At Risk ◽  
Energy Transfer ◽  
Proton Therapy ◽  
Linear Energy Transfer ◽  
Organs At Risk ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
High Linear Energy Transfer

scholarly journals Linear energy transfer distributions in the brainstem depending on tumour location in intensity-modulated proton therapy of paediatric cancer

2017 ◽  
Vol 56 (6) ◽  
pp. 763-768 ◽  
Author(s):  
Lars Fredrik Fjæra ◽  
Zuofeng Li ◽  
Kristian S. Ytre-Hauge ◽  
Ludvig P. Muren ◽  
Daniel J. Indelicato ◽  
...  
Keyword(s):  
Energy Transfer ◽  
Proton Therapy ◽  
Linear Energy Transfer ◽  
Paediatric Cancer ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Tumour Location

Reply to Comment on ‘Linear energy transfer incorporated intensity modulated proton therapy optimization’

2019 ◽  
Vol 64 (5) ◽  
pp. 058002
Author(s):  
Wenhua Cao ◽  
Azin Khabazian ◽  
Pablo Yepes ◽  
Gino Lim ◽  
Falk Poenisch ◽  
...  
Keyword(s):  
Energy Transfer ◽  
Proton Therapy ◽  
Linear Energy Transfer ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated

scholarly journals Linear Energy Transfer-Guided Optimization in Intensity Modulated Proton Therapy: Feasibility Study and Clinical Potential

2013 ◽  
Vol 87 (1) ◽  
pp. 216-222 ◽  
Author(s):  
Drosoula Giantsoudi ◽  
Clemens Grassberger ◽  
David Craft ◽  
Andrzej Niemierko ◽  
Alexei Trofimov ◽  
...  
Keyword(s):  
Energy Transfer ◽  
Feasibility Study ◽  
Proton Therapy ◽  
Linear Energy Transfer ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Clinical Potential

scholarly journals The Potential Role of Intensity-Modulated Proton Therapy in Hepatic Carcinoma in Mitigating the Risk of Dose De-Escalation

2020 ◽  
Vol 19 ◽  
pp. 153303382098041
Author(s):  
Luca Cozzi ◽  
Tiziana Comito ◽  
Mauro Loi ◽  
Antonella Fogliata ◽  
Ciro Franzese ◽  
...  
Keyword(s):  
At Risk ◽  
Proton Therapy ◽  
Organs At Risk ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Number Of Patients ◽  
Target Volumes ◽  
Dosimetric Analysis

Purpose: To investigate the role of intensity-modulated proton therapy (IMPT) for hepatocellular carcinoma (HCC) patients to be treated with stereotactic body radiation therapy (SBRT) in a risk-adapted dose prescription regimen. Methods: A cohort of 30 patients was retrospectively selected as “at-risk” of dose de-escalation due to the proximity of the target volumes to dose-limiting healthy structures. IMPT plans were compared to volumetric modulated arc therapy (VMAT) RapidArc (RA) plans. The maximum dose prescription foreseen was 75 Gy in 3 fractions. The dosimetric analysis was performed on several quantitative metrics on the target volumes and organs at risk to identify the relative improvement of IMPT over VMAT and to determine if IMPT could mitigate the need of dose reduction and quantify the consequent potential patient accrual rate for protons. Results: IMPT and VMAT plans resulted in equivalent target dose distributions: both could ensure the required coverage for CTV and PTV. Systematic and significant improvements were observed with IMPT for all organs at risk and metrics. An average gain of 9.0 ± 11.6, 8.5 ± 7.7, 5.9 ± 7.1, 4.2 ± 6.4, 8.9 ± 7.1, 6.7 ± 7.5 Gy was found in the near-to-maximum doses for the ribs, chest wall, heart, duodenum, stomach and bowel bag respectively. Twenty patients violated one or more binding constraints with RA, while only 2 with IMPT. For all these patients, some dose de-intensification would have been required to respect the constraints. For photons, the maximum allowed dose ranged from 15.0 to 20.63 Gy per fraction while for the 2 proton cases it would have been 18.75 or 20.63 Gy. Conclusion: The results of this in-silico planning study suggests that IMPT might result in advantages compared to photon-based VMAT for HCC patients to be treated with ablative SBRT. In particular, the dosimetric characteristics of protons may avoid the need for dose de-escalation in a risk-adapted prescription regimen for those patients with lesions located in proximity of dose-limiting healthy structures. Depending on the selection thresholds, the number of patients eligible for treatment at the full dose can be significantly increased with protons.

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