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Evaluation of inten...
Evaluation of intensity-modulated electron FLASH radiotherapy in a clinical setting using veterinary cases
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- Konradsson, Elise (författare)
- Lund University,Lunds universitet,Medicinsk strålningsfysik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Radiotherapy Physics,Forskargrupper vid Lunds universitet,Medical Radiation Physics, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
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- Szecsenyi, Rebecka Ericsson (författare)
- Skåne University Hospital
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- Adrian, Gabriel (författare)
- Lund University,Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Strålterapi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Radiation therapy,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Coskun, Mizgin (författare)
- Lund University
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- Børresen, Betina (författare)
- University of Copenhagen
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- Arendt, Maja Louise (författare)
- University of Copenhagen
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- Erhart, Kevin (författare)
- .decimal, LLC
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- Bäck, Sven Å.J. (författare)
- Lund University,Lunds universitet,Medicinsk strålningsfysik, Malmö,Forskargrupper vid Lunds universitet,Radiotherapy Physics,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Medical Radiation Physics, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments
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- Petersson, Kristoffer (författare)
- Lund University,Lunds universitet,Radiotherapy Physics,Forskargrupper vid Lunds universitet,Lund University Research Groups
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- Ceberg, Crister (författare)
- Lund University,Lunds universitet,Medicinsk strålningsfysik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Radiotherapy Physics,Forskargrupper vid Lunds universitet,Rausinglaboratoriet i Lund - Tumörsektionen,LU profilområde: Ljus och material,Lunds universitets profilområden,Medical Radiation Physics, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Rausing laboratory of Lund - Tumor section,LU Profile Area: Light and Materials,Lund University Profile areas
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(creator_code:org_t)
- 2023
- 2023
- Engelska 11 s.
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Ingår i: Medical Physics. - 0094-2405. ; 50:10, s. 6569-6579
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Purpose: The increased normal tissue tolerance for FLASH radiotherapy (FLASH-RT), as compared to conventional radiotherapy, was first observed in ultra-high dose rate electron beams. Initial clinical trials in companion animals have revealed a high risk of developing osteoradionecrosis following high-dose single-fraction electron FLASH-RT, which may be related to inhomogeneities in the dose distribution. In the current study, we aim to evaluate the possibilities of intensity-modulated electron FLASH-RT in a clinical setting to ensure a homogeneous dose distribution in future veterinary and human clinical trials. Methods: Our beam model in the treatment planning system electronRT (.decimal, LLC, Sanford, FL, USA) was based on a 10-MeV electron beam from a clinical linear accelerator used to treat veterinary patients with FLASH-RT in a clinical setting. In electronRT, the beam can be intensity-modulated using tungsten island blocks in the electron block cutout, and range-modulated using a customized bolus with variable thickness. Modulations were first validated in a heterogeneous phantom by comparing measured and calculated dose distributions. To evaluate the impact of intensity modulation in superficial single-fraction FLASH-RT, a treatment planning study was conducted, including eight canine cancer patient cases with simulated tumors in the head-and-neck region. For each case, treatment plans with and without intensity modulation were created for a uniform bolus and a range-modulating bolus. Treatment plans were evaluated using a target dose homogeneity index (HI), a conformity index (CI), the near-maximum dose outside the target ((Figure presented.)), and the near-minimum dose to the target ((Figure presented.)). Results: By adding intensity modulation to plans with a uniform bolus, the HI could be improved (p = 0.017). The combination of a range-modulating bolus and intensity modulation provided a further significant improvement of the HI as compared to using intensity modulation in combination with a uniform bolus (p = 0.036). The range-modulating bolus also improved the CI compared to using a uniform bolus, both with an open beam (p = 0.046) and with intensity modulation (p = 0.018), as well as increased the (Figure presented.) (p = 0.036 with open beam and p = 0.05 with intensity modulation) and reduced the median (Figure presented.) (not significant). Conclusions: By using intensity-modulated electron FLASH-RT in combination with range-modulating bolus, the target dose homogeneity and conformity in canine patients with simulated tumors in complex areas in the head-and-neck region could be improved. By utilizing this technique, we hope to decrease the dose outside the target volume and avoid hot spots in future clinical electron FLASH-RT studies, thereby reducing the risk of radiation-induced toxicity.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
Nyckelord
- conformity
- electrons
- FLASH
- homogeneity
- treatment planning
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Konradsson, Elis ...
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Szecsenyi, Rebec ...
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Adrian, Gabriel
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Coskun, Mizgin
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Børresen, Betina
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Arendt, Maja Lou ...
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Erhart, Kevin
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Bäck, Sven Å.J.
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Petersson, Krist ...
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Ceberg, Crister
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