Carbon-ion pencil beam scanning for thoracic treatment – initiation report and dose metrics evaluation

Abstract Carbon-ion beam scanning has not previously been used for moving tumor treatments. We have commenced respiratory-gated carbon-ion radiotherapy (CIRT) in the thoracic and abdominal regions under free-breathing conditions as a clinical trial. This study aimed to investigate this treatment in the lungs in comparison with passive scattering CIRT. Five patients had thoracic tumors treated with carbon-ion scanned beams using respiratory gating. We analyzed the actual treatments and calculated passive scattering treatment plans based on the same planning CT. We evaluated tumor size until 3 months post treatment and each treatment plan regarding dose delivered to 95% of the clinical target volume (CTV-D95), mean lung dose, percentage of lung receiving at least 5 Gy (RBE) (Lung-V5), Lung-V10, Lung-V20, heart maximum dose (Dmax), esophagus Dmax, cord Dmax and skin Dmax. Obvious tumor deterioration was not observed up to 3 months post treatment. The dose evaluation metrics were similar item by item between respiratory-gated scanned CIRT and passive scattering CIRT. In conclusion, scanned beam CIRT provided treatments equivalent to passive scattering CIRT for thoracic tumors. Increased sample numbers and longer-term observation are needed.

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Patient handling system for carbon ion beam scanning therapy

Journal of Applied Clinical Medical Physics ◽

10.1120/jacmp.v13i6.3926 ◽

2012 ◽

Vol 13 (6) ◽

pp. 226-240 ◽

Cited By ~ 24

Author(s):

Shinichiro Mori ◽

Toshiyuki Shirai ◽

Yuka Takei ◽

Takuji Furukawa ◽

Taku Inaniwa ◽

...

Keyword(s):

Ion Beam ◽

Patient Handling ◽

Beam Scanning ◽

Handling System ◽

Carbon Ion ◽

Carbon Ion Beam

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Carbon Ion Beam Radiotherapy for Sinonasal Malignant Tumors Invading Skull Base

Case Reports in Otolaryngology ◽

10.1155/2014/241856 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Nobuo Ohta ◽

Yusuke Suzuki ◽

Azusa Hasegawa ◽

Masaru Aoyagi ◽

Seiji Kakehata

Keyword(s):

Skull Base ◽

Malignant Tumors ◽

Ion Beam ◽

Target Volume ◽

Carbon Ion ◽

School Of Medicine ◽

Retrospective Clinical Study ◽

Radiation Induced ◽

Carbon Ion Beam ◽

Observation Period

Objective. To evaluate the treatment outcome and prognostic factors in patients with sinonasal malignant tumors invading skull base.Study Design and Setting. A retrospective clinical study at the Yamagata University School of Medicine.Subjects and Methods. Three patients with sinonasal malignant tumors invading skull base were presented in present study. All patients were treated with carbon ion beam radiotherapy. The prescribed dose to the center of the clinical target volume was 64.0 GyE/16 fractions over 4 weeks at 4.0 GyE/fraction per day.Results. All patients completed carbon ion beam radiotherapy without an interval. The mean observation period was 39.6 months (range: 11–54 months). There were no local or regional recurrences in all cases; however, one patient had a metastasis in distant organs. Regarding the complications, visual loss was observed in one eye of one patient whose optic nerve was entirely involved by the tumor and field of carbon ion beam radiotherapy. Radiation induced brain injury was observed in two patients; however, these patients do not complain about neurological abnormality and had no treatment for radiation induced brain necrosis.Conclusions. Carbon ion beam radiotherapy for sinonasal malignant tumors invading the skull base showed therapeutic effectiveness.

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Evaluation of Safety for Scanning Carbon-Ion Radiotherapy in Hemodialysis Patients with Prostate Cancer

10.21203/rs.3.rs-1153921/v1 ◽

2021 ◽

Author(s):

Yosuke Takakusagi ◽

Makito Suga ◽

Yohsuke Kusano ◽

Kio Kano ◽

Satoshi Shima ◽

...

Keyword(s):

Prostate Cancer ◽

Treatment Plan ◽

Late Phase ◽

Target Volume ◽

Carbon Ion Radiotherapy ◽

Cancer Center ◽

Scanning Method ◽

Carbon Ion ◽

Genitourinary Toxicity ◽

Ct Analysis

Abstract Background/Aim The efficacy and safety of carbon-ion radiotherapy (CIRT) for prostate cancer have already been demonstrated. The number of hemodialysis (HD) patients is increasing. Although the toxicity of CIRT in HD patients may be more severe, it has been insufficiently investigated. Therefore, we retrospectively analyzed the safety of CIRT for HD patients with prostate cancer in the present study. Materials and Methods Five HD patients with prostate cancer who underwent CIRT at the Kanagawa Cancer Center during November 2015–2020 were included in this study. CIRT was delivered by the raster scanning method (sCIRT). Adverse events were assessed using the CTCAE v5.0. The dose-volume histogram (DVH) parameters of the target volume and normal organs were evaluated between initial planning computed tomography (CT) and in-room CT images. Results In the acute phase, Grade 1 genitourinary toxicity was recorded in 1 patient. In the late phase, Grade 1 genitourinary toxicity was recorded in 2 patients. No gastrointestinal toxicities were noted during the follow-up period. In-room CT analysis revealed no significant differences among all DVH parameters of the target volume and normal organs when compared with the treatment plan dose. Conclusions The safety of sCIRT for prostate cancer in HD patients was investigated in the present study. In-room CT analysis suggested the robustness of the treatment plan. According to the present results, sCIRT for prostate cancer can be safely performed in HD patients.

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Abstract 16347: Simplified Workflow to Improve the Precision of Non-invasive Radio-ablation of Ventricular Tachycardia Storm

Circulation ◽

10.1161/circ.142.suppl_3.16347 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Gordon Ho ◽

Todd Atwood ◽

Andrew Bruggeman ◽

Kevin Moore ◽

Elliot R McVeigh ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Critically Ill ◽

Respiratory Gating ◽

Free Breathing ◽

3D Models ◽

Target Volume ◽

Stereotactic Ablative Radiotherapy ◽

Gated Radiotherapy ◽

Non Invasive

Background: Stereotactic ablative radiotherapy (SAbR) is an emerging therapy for ventricular tachycardia (VT) storm, but the feasibility and outcomes guided by computational 12-lead ECG mapping and respiratory-gated radiation delivery have not been reported. Hypothesis: We hypothesized that a novel 12-lead ECG-based mapping system and respiratory-gated radiotherapy delivery may simplify the workflow and improve precision of SAbR in critically ill patients with VT storm. Methods: We enrolled patients with VT storm who were not candidates for catheter ablation. VT was induced using non-invasive stimulation and recorded on 12-lead ECGs. Computational ECG mapping was performed to localize VT exit sites. Target volumes were contoured onto an averaged free-breathing CT. Ionizing radiation (25 Gy) was delivered using a linear accelerator (Varian, Palo Alto). In patients with significant respiratory motion, radiotherapy was delivered at end-expiration, guided by ICD lead fiducials. Results: In 5 patients (age 74±6.1 years, EF 29±14%) refractory to 2±1 ablation procedures, 1.5±0.6 VT morphologies were localized on 3D models (Fig 1A) using ECG-based mapping (mapping time 1.2±0.3 min). In patients whom respiratory gating (Fig 1B) was used prospectively due to respiratory variation, the planned target volume (PTV) was smaller compared to patients who were not gated (71 ± 7 vs 153 ± 35 cc, p<0.01). These patients also had VT targets (crux or inferior LV) close to the stomach, and did not experience adverse events. ICD shocks were decreased after SAbR compared to before (0.25±0.5 vs 26±19 shocks, p<0.001) at 4.4±3.4 months follow-up. Conclusion: Non-invasive computational mapping based upon the 12-lead ECG alone simplifies radioablation workflow in critically ill VT storm patients and reduces the burden of ICD shocks. Respiratory gated radiotherapy ablation appears feasible and may help reduce target volume of therapy. Studies with longer follow-up are ongoing.

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Development of digital reconstructed radiography software at new treatment facility for carbon-ion beam scanning of National Institute of Radiological Sciences

Australasian Physical & Engineering Sciences in Medicine ◽

10.1007/s13246-012-0142-4 ◽

2012 ◽

Vol 35 (2) ◽

pp. 221-229 ◽

Cited By ~ 3

Author(s):

Shinichiro Mori ◽

Taku Inaniwa ◽

Motoki Kumagai ◽

Tsunekazu Kuwae ◽

Yuka Matsuzaki ◽

...

Keyword(s):

Ion Beam ◽

Treatment Facility ◽

Beam Scanning ◽

Carbon Ion ◽

Carbon Ion Beam ◽

New Treatment

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Adaptive planning based on single beam optimization in passive scattering carbon ion radiotherapy for patients with pancreatic cancer

Radiation Oncology ◽

10.1186/s13014-021-01841-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yang Li ◽

Yoshiki Kubota ◽

Masahiko Okamoto ◽

Shintaro Shiba ◽

Shohei Okazaki ◽

...

Keyword(s):

Pancreatic Cancer ◽

Carbon Ion Radiotherapy ◽

Adaptive Planning ◽

Carbon Ion ◽

Single Beam ◽

Original Plan ◽

Image Registration Algorithm ◽

Passive Scattering ◽

Accumulated Dose ◽

Dose Difference

Abstract Background Daily anatomical deviations may distort the dose distribution in carbon ion radiotherapy (CIRT), which may cause treatment failure. Therefore, this study aimed to perform re-planning to maintain the dose coverage in patients with pancreatic cancer with passive scattering CIRT. Methods Eight patients with pancreatic cancer and 95 daily computed tomography (CT) sets were examined. Two types of adaptive plans based on new range compensators (RCs) (AP-1) and initial RCs (AP-2) were generated. In AP-2, each beam was optimized by manually adjusting the range shifter thickness and spread-out Bragg peak size to make dose reduction by < 3% of the original plan. Doses of the original plan with bone matching (BM) and tumor matching (TM) were examined for comparison. We calculated the accumulated dose using the contour and intensity-based deformable image registration algorithm. The dosimetric differences in respect to the original plan were compared between methods. Results Using TM and BM, mean ± standard deviations of daily CTV V95 (%) difference from the original plan was − 5.1 ± 6.2 and − 8.8 ± 8.8, respectively, but 1.2 ± 3.4 in AP-1 and − 0.5 ± 2.1 in AP-2 (P < 0.001). AP-1 and AP-2 enabled to maintain a satisfactory accumulated dose in all patients. The dose difference was 1.2 ± 2.8, − 2,1 ± 1.7, − 7.1 ± 5.2, and − 16.5 ± 15.0 for AP-1, AP-2, TM, and BM, respectively. However, AP-2 caused a dose increase in the duodenum, especially in the left–right beam. Conclusions The possible dose deterioration should be considered when performing the BM, even TM. Re-planning based on single beam optimization in passive scattering CIRT seems an effective and safe method of ensuring the treatment robustness in pancreatic cancer. Further study is necessary to spare healthy tissues, especially the duodenum.

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