In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer |
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| Institution: | 1. GSI Helmholtz Centre for Heavy Ion Research, Planckstr. 1, 64291 Darmstadt, Germany;2. Champalimaud Centre for the Unknown, Av. Brasília, 1400-038 Lisbon, Portugal;1. Department of Physics, Section of Nuclear and Particle Physics, University of Athens, Panepistimioupolis, Ilissia, 15771 Athens, Greece;2. Department of Philosophy and History of Science, University of Athens, Panepistimioupolis, Ilissia, 15771 Athens, Greece;1. Department of Radiation Oncology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel;2. Department of Pulmonary Medicine, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel;3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;1. Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Belgium;2. Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Belgium;1. UCLouvain, Institut de Recherche Experimentale et Clinique (IREC), Center of Molecular Imaging, Radiotherapy and Oncology(MIRO), 1200 Brussels, Belgium;2. Radiation Oncology Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium;3. KULeuven Department of Oncology, Laboratory of Experimental Radiotherapy, 3000 Leuven, Belgium |
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| Abstract: | PurposeStereotactic body image guided radiation therapy (SBRT) shows good results for lung cancer treatment. Better normal tissue sparing might be achieved with scanned carbon ion therapy (PT). Therefore an in silico trial was conducted to find potential advantages of and patients suited for PT.MethodsFor 19 patients treated with SBRT, PT plans were calculated on 4D-CTs with simulated breathing motion. Prescribed single fraction dose was 24 Gy and OAR constraints used for photon planning were respected. Motion was mitigated by rescanning and range-adapted ITVs. Doses were compared to the original SBRT plans.ResultsCTV coverage was the same in SBRT and PT. The field-specific PTV including range margins for PT was 1.5 (median, 25–75% 1.3–2.1) times larger than for SBRT. Nevertheless, maximum point dose and mean dose in OARs were higher in SBRT by 2.8 (1.6–3.7) Gy and 0.7 (0.3–1.6) Gy, respectively. Patients with a CTV >2.5 cc or with multiple lung lesions showed larger differences in OAR doses in favor of PT.ConclusionsPatients receive less dose in critical OARs such as heart, spinal cord, esophagus, trachea and aorta with PT, while maintaining the same target coverage. Patients with multiple or larger lesions are particularly suited for PT. |
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| Keywords: | SDRT Particle therapy Lung cancer Motion mitigation Single fraction |
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