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Pencil beam scannin...
Pencil beam scanning proton therapy for mediastinal lymphomas in deep inspiration breath-hold : a retrospective assessment of plan robustness
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- Hörberger, Filip (author)
- Skane Univ Hosp, Dept Hematol Oncol & Radiat Phys, Radiat Phys, Lund, Sweden.;Skane Univ Hosp, Klinikgatan 5, S-22242 Lund, Sweden.,Skåne University Hospital
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- Andersson, Karin M. (author)
- Skand Clin, Dept Med Phys, Uppsala, Sweden.,The Skandion Clinic
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- Enmark, Marika (author)
- Skane Univ Hosp, Dept Hematol Oncol & Radiat Phys, Radiat Phys, Lund, Sweden.;Skand Clin, Dept Med Phys, Uppsala, Sweden.,Skåne University Hospital,The Skandion Clinic
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- Kristensen, Ingrid (author)
- Lund University,Lunds universitet,Skane Univ Hosp, Dept Hematol Oncol & Radiat Phys, Radiat Phys, Lund, Sweden.;Lund Univ, Dept Clin Sci, Oncol, Lund, Sweden.,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,Skåne University Hospital
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- Flejmer, Anna M., 1971- (author)
- Uppsala University,Uppsala universitet,Institutionen för immunologi, genetik och patologi,Skand Clin, Dept Med Phys, Uppsala, Sweden.;Uppsala Univ Hosp, Dept Oncol, Uppsala, Sweden.
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- Edvardsson, Anneli (author)
- Lund University,Lunds universitet,Radiotherapy Physics,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital,Skane Univ Hosp, Dept Hematol Oncol & Radiat Phys, Radiat Phys, Lund, Sweden.;Lund Univ, Dept Clin Sci Lund, Med Radiat Phys, Lund, Sweden.
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Skane Univ Hosp, Dept Hematol Oncol & Radiat Phys, Radiat Phys, Lund, Sweden;Skane Univ Hosp, Klinikgatan 5, S-22242 Lund, Sweden. Skåne University Hospital (creator_code:org_t)
- Medical Journals Sweden, 2024
- 2024
- English.
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In: Acta Oncologica. - : Medical Journals Sweden. - 0284-186X .- 1651-226X. ; 63, s. 62-69
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Abstract
Subject headings
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- Purpose/background: The aim of this study was to evaluate pencil beam scanning (PBS) proton therapy (PT) in deep inspiration breath-hold (DIBH) for mediastinal lymphoma patients, by retrospectively evaluating plan robustness to the clinical target volume (CTV) and organs at risk (OARs) on repeated CT images acquired throughout treatment.Methods: Sixteen mediastinal lymphoma patients treated with PBS-PT in DIBH were included. Treatment plans (TPs) were robustly optimized on the CTV (7 mm/4.5%). Repeated verification CTs (vCT) were acquired during the treatment course, resulting in 52 images for the entire patient cohort. The CTV and OARs were transferred from the planning CT to the vCTs with deformable image registration and the TPs were recalculated on the vCTs. Target coverage and OAR doses at the vCTs were compared to the nominal plan. Deviation in lung volume was also calculated.Results: The TPs demonstrated high robust target coverage throughout treatment with D98%,CTV deviations within 2% for 14 patients and above the desired requirement of 95% for 49/52 vCTs. However, two patients did not achieve a robust dose to CTV due to poor DIBH reproducibility, with D98%,CTV at 78 and 93% respectively, and replanning was performed for one patient. Adequate OAR sparing was achieved for all patients. Total lung volume variation was below 10% for 39/52 vCTs.Conclusion: PBS PT in DIBH is generally a robust technique for treatment of mediastinal lymphomas. However, closely monitoring the DIBH-reproducibility during treatment is important to avoid underdosing CTV and achieve sufficient dose-sparing of the OARs.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
Keyword
- Proton therapy
- mediastinal lymphomas
- deep inspiration breath- hold
- Robust optimization
- repeated verification CTs
Publication and Content Type
- ref (subject category)
- art (subject category)
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