scholarly journals Intensity-Modulated Proton Therapy (IMPT) Treatment of Angiosarcoma of the Face and Scalp

2021 ◽  
Vol 8 (1) ◽  
pp. 304-310
Author(s):  
Ashley Hunzeker ◽  
Daniel W. Mundy ◽  
Jiasen Ma ◽  
Trey C. Mullikin ◽  
Robert L. Foote
Keyword(s):  
Monte Carlo ◽  
Surgical Resection ◽  
Proton Therapy ◽  
Target Volume ◽  
Preoperative Treatment ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
The Face ◽  
Homogeneous Dose ◽  
Therapy Treatment

Abstract Purpose To successfully plan and treat a patient with diffuse angiosarcoma involving the face and scalp with intensity-modulated proton therapy (IMPT) before surgical resection. Materials and Methods A patient presented to the radiation oncology department for preoperative treatment of an angiosarcoma diffusely involving the face and scalp. A 4-field IMPT technique was used to create a homogeneous dose distribution to the entire target volume while sparing underlying critical structures from toxicity and low-dose spread. A custom Monte Carlo optimizer was necessary to achieve treatment goals. Biological dose was evaluated with a linear energy transfer–based biological enhancement model. Robustness criteria were evaluated per department standard. The patient was successfully planned and treated according to clinical goals. Results The patient successfully completed the course of IMPT and was able to undergo surgical resection. Pathology indicated no presence of angiosarcoma. Conclusion IMPT using a custom Monte Carlo optimizer is a suitable radiation therapy treatment option for patients with diffuse angiosarcoma of the scalp and face.

Technical Note: Integrating an open source Monte Carlo code “MCsquare” for clinical use in intensity‐modulated proton therapy

2020 ◽  
Vol 47 (6) ◽  
pp. 2558-2574 ◽  
Author(s):  
Wei Deng ◽  
James E. Younkin ◽  
Kevin Souris ◽  
Sheng Huang ◽  
Kurt Augustine ◽  
...  
Keyword(s):  
Monte Carlo ◽  
Open Source ◽  
Proton Therapy ◽  
Technical Note ◽  
Monte Carlo Code ◽  
Clinical Use ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated

SU-G-TeP1-06: Fast GPU Framework for Four-Dimensional Monte Carlo in Adaptive Intensity Modulated Proton Therapy (IMPT) for Mobile Tumors

2016 ◽  
Vol 43 (6Part26) ◽  
pp. 3653-3653
Author(s):  
P Botas ◽  
C Grassberger ◽  
G Sharp ◽  
N Qin ◽  
X Jia ◽  
...  
Keyword(s):  
Monte Carlo ◽  
Proton Therapy ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated

scholarly journals Is an analytical dose engine sufficient for intensity modulated proton therapy in lung cancer?

2020 ◽  
Vol 93 (1107) ◽  
pp. 20190583 ◽  
Author(s):  
Suliana Teoh ◽  
Francesca Fiorini ◽  
Ben George ◽  
Katherine A Vallis ◽  
Frank Van den Heuvel
Keyword(s):  
Lung Cancer ◽  
Proton Therapy ◽  
Dose Calculation ◽  
Target Volume ◽  
Pass Rates ◽  
Final Dose ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Mediastinal Disease ◽  
Mediastinal Involvement

Objective: To identify a subgroup of lung cancer plans where the analytical dose calculation (ADC) algorithm may be clinically acceptable compared to Monte Carlo (MC) dose calculation in intensity modulated proton therapy (IMPT). Methods: Robust-optimised IMPT plans were generated for 20 patients to a dose of 70 Gy (relative biological effectiveness) in 35 fractions in Raystation. For each case, four plans were generated: three with ADC optimisation using the pencil beam (PB) algorithm followed by a final dose calculation with the following algorithms: PB (PB-PB), MC (PB-MC) and MC normalised to prescription dose (PB-MC scaled). A fourth plan was generated where MC optimisation and final dose calculation was performed (MC-MC). Dose comparison and γ analysis (PB-PB vs PB-MC) at two dose thresholds were performed: 20% (D20) and 99% (D99) with PB-PB plans as reference. Results: Overestimation of the dose to 99% and mean dose of the clinical target volume was observed in all PB-MC compared to PB-PB plans (median: 3.7 Gy(RBE) (5%) (range: 2.3 to 6.9 Gy(RBE)) and 1.8 Gy(RBE) (3%) (0.5 to 4.6 Gy(RBE))). PB-MC scaled plans resulted in significantly higher CTVD2 compared to PB-PB (median difference: −4 Gy(RBE) (−6%) (-5.3 to −2.4 Gy(RBE)), p ≤ .001). The overall median γ pass rates (3%–3 mm) at D20 and D99 were 93.2% (range:62.2–97.5%) and 71.3 (15.4–92.0%). On multivariate analysis, presence of mediastinal disease and absence of range shifters were significantly associated with high γ pass rates. Median D20 and D99 pass rates with these predictors were 96.0% (95.3–97.5%) and 85.4% (75.1–92.0%). MC-MC achieved similar target coverage and doses to OAR compared to PB-PB plans. Conclusion: In the presence of mediastinal involvement and absence of range shifters Raystation ADC may be clinically acceptable in lung IMPT. Otherwise, MC algorithm would be recommended to ensure accuracy of treatment plans. Advances in knowledge: Although MC algorithm is more accurate compared to ADC in lung IMPT, ADC may be clinically acceptable where there is mediastinal involvement and absence of range shifters.

scholarly journals A comprehensive dosimetric study of Monte Carlo and pencil-beam algorithms on intensity-modulated proton therapy for breast cancer

2018 ◽  
Vol 20 (1) ◽  
pp. 128-136 ◽  
Author(s):  
Xiaoying Liang ◽  
Zuofeng Li ◽  
Dandan Zheng ◽  
Julie A. Bradley ◽  
Michael Rutenberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Monte Carlo ◽  
Proton Therapy ◽  
Pencil Beam ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Dosimetric Study

scholarly journals Dosimetric Comparison of Helical Tomotherapy, Volumetric-Modulated Arc Therapy, and Intensity-Modulated Proton Therapy for Angiosarcoma of the Scalp

2021 ◽  
Vol 20 ◽  
pp. 153303382098586
Author(s):  
Tomoki Mizuno ◽  
Natsuo Tomita ◽  
Taiki Takaoka ◽  
Masashi Tomida ◽  
Hiroshi Fukuma ◽  
...  
Keyword(s):  
Proton Therapy ◽  
Helical Tomotherapy ◽  
Organs At Risk ◽  
Volumetric Modulated Arc Therapy ◽  
Target Volume ◽  
The Other ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Arc Therapy ◽  
Dose Constraint

Objective: We compared radiotherapy plans among helical tomotherapy (HT), volumetric-modulated arc therapy (VMAT), and intensity-modulated proton therapy (IMPT) for angiosarcoma of the scalp (AS). Methods: We conducted a planning study for 19 patients with AS. The clinical target volume (CTV) 1 and CTV2 were defined as the gross tumor volume with a specific margin and total scalp, respectively. For HT and VMAT, the planning target volume (PTV) 1 and PTV2 were defined as CTV1 and CTV2 with 0.5-cm margins, respectively. For IMPT, robust optimization was used instead of a CTV-PTV margin (i.e. CTV robust). The targets of the HT and VMAT plans were the PTV, whereas the IMPT plans targeted the CTV robust. In total, 70 Gy and 56 Gy were prescribed as the D95% (i.e. dose to 95% volume) of PTV1 (or CTV1 robust) and PTV2 (or CTV2 robust), respectively, using the simultaneous integrated boost (SIB) technique. Other constraint goals were also defined for the target and organs at risk (OAR). Results: All dose constraint parameters for the target and OAR met the goals within the acceptable ranges for the 3 techniques. The coverage of the targets replaced by D95% and D98% were almost equivalent among the 3 techniques. The homogeneity index of PTV1 or CTV1 robust was equivalent among the 3 techniques, whereas that of PTV2 or CTV2 robust was significantly higher in the IMPT plans than in the other plans. IMPT reduced the Dmean of the brain and hippocampus by 49% to 95%, and the Dmax of the spinal cord, brainstem, and optic pathway by 70% to 92% compared with the other techniques. Conclusion: The 3 techniques with SIB methods provided sufficient coverage and satisfactory homogeneity for the targets, but IMPT achieved the best OAR sparing.

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