Comparison of photon volumetric modulated arc therapy, intensity-modulated proton therapy, and intensity-modulated carbon ion therapy for delivery of hypo-fractionated thoracic radiotherapy

Chi, Alexander; Lin, Lien-Chun; Wen, Sijin; Yan, Hui; Hsi, W

doi:10.1186/s13014-017-0866-0

Cited by 6 publications

(6 citation statements)

References 48 publications

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“…The additional benefit that carbon ions have, over other charged particles like protons, is an increased biological effectiveness because of dense ionization and the resulting complex DNA damage . Carbon ion treatment can also improve tumor control without increasing toxicity and is considered a radical nonsurgical therapy that achieves high local control rates without severe adverse effects . Charged particle therapy, especially with carbon ions, is known to be effective for various treatment sites including lung and may even be a safer option than photon SBRT and protons in case of large or central tumors and poor pulmonary function …”

Section: Introductionmentioning

confidence: 99%

Dosimetric evaluation of 4D‐CBCT reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for carbon ion therapy of lung cancer

et al. 2019

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Purpose Motion management is critical for the efficacy of carbon ion therapy for moving targets such as lung tumors. We evaluated the feasibility of using four‐dimensional cone beam computed tomography (4D‐CBCT) reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for dose calculation and accumulation in carbon ion treatment of lung cancer. Methods Motion‐compensated 4D‐CBCT images were reconstructed with the SMEIR algorithm to capture the most updated anatomy and motion with an updated interphase motion model on the treatment day. Projections of all CBCT phases were simulated from the planning 4D‐CT by the ray tracing technique. Treatment planning and dose calculation were performed with a GPU‐based Monte Carlo dose calculation software for carbon ion therapy. The treatment plan was optimized on the average computed tomography (CT) to obtain optimal intensity of the carbon ions. From the optimized plan, dose distributions on individual phases of 4D‐CT and 4D‐CBCT were calculated by the Monte Carlo‐based dose engine. Dose accumulation was performed on 4D‐CBCT images using deformable vector fields (DVF) generated by SMEIR. The accumulated planning target volume (PTV) dose based on 4D‐CBCT was then compared to the accumulated dose calculated on 4D‐CT, where the DVFs between different phases were obtained by the demons deformable registration algorithm. Results Dose value histograms (DVH) as well as absolute deviations of the maximum dose (ΔDmax), mean dose (ΔDmean), and dose coverage metrics (ΔV95% and ΔV100%) for PTV were quantitatively evaluated for the two sets of plans. Good agreement was found between the 4D‐CT and 4D‐CBCT‐based PTV‐DVH curves. The average values of ΔDmax, ΔDmean,ΔV95%, and ΔV100% calculated between the 4D‐CT and SMEIR‐4D‐CBCT‐based plans were 1.91%, 3.55%, 2.12%, and 1.15%, respectively, for the PTVs of ten patient case studies. Conclusions Based on these results, SMEIR‐reconstructed 4D‐CBCTs can potentially be used for motion estimation, dose evaluation, and adaptive treatment planning in lung cancer carbon ion therapy.

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Section: Introductionmentioning

confidence: 99%

Dosimetric evaluation of 4D‐CBCT reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for carbon ion therapy of lung cancer

et al. 2019

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“…Studies on IMCT remain limited. Chi et al compared the dose distribution of IMCT, IMPT, and volumetric modulated arc therapy in thoracic radiotherapy (17). They found no significant difference in PTV coverage between the three modalities, and IMCT was able to reduce low-dose areas in the lungs.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike single field uniform dose (SFUD) irradiation, which irradiates uniform doses with each beam, IMCT is an irradiation method in which the individual beams are irradiated at non-uniform doses and the total dose is equalized by the sum of the individual beams (16). Several dosimetric studies have reported that good dose distribution can be obtained with IMCT (17,18). Furthermore, reports on the clinical application of IMCT are limited, and results of IMCT in head and neck cancer have been reported (19,20).…”

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confidence: 99%

Clinical Outcomes of Intensity-modulated Carbon-ion Radiotherapy for Bone and Soft Tissue Tumors

et al. 2023

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Background/Aim: Carbon-ion radiotherapy (CIRT) for bone and soft tissue tumors (BSTs) has been reported to have favorable clinical outcomes. Intensity-modulated CIRT (IMCT) techniques have been developed to further reduce dose delivery to adjacent organs compared to conventional CIRT. We retrospectively analyzed the clinical results of IMCT for BSTs and investigated treatment efficacy and toxicity. Patients and Methods: This study included 9 consecutive BSTs patients who underwent IMCT at the Kanagawa Cancer Center from January 2016 to April 2021. IMCT was administered at a dose of 60.8-70.4 Gy (relative biological effect) in 16 fractions. The time to event was calculated from the initiation of IMCT. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 5.0. Results: The median age was 49 (range=16-71) years. The median observation period was 57.6 (range=7.0-77.8) months. There were 7 and 2 cases for IMCT because of proximity to the spinal cord and intestinal tract, respectively. There was one death during the observation period, which occurred 7.0 months after the initiation of treatment. Clinical recurrence occurred in 3 patients at 1.3, 17.8, and 22.4 months after the initiation of treatment, respectively. Acute toxicity of Grade 2 or higher was seen in 2 patients with Grade 2 pharyngeal mucositis. Late toxicities of Grade 2 or higher included 1 case each of Grade 2 neuralgia and peripheral neuropathy, as well as 1 case of Grade 3 fracture. Conclusion: IMCT for BSTs showed good local therapeutic efficacy and tolerable toxicity in patients with bone and soft tissue tumors.

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“…Further, the literature is replete with studies that explored the superior conformity and theoretical radiobiological advantages of carbon ion therapy regarding tumor control (Weber et al 2009, Grun et al 2015, Dokic et al 2016, Chi et al 2017. It has also been suggested that conformity is even more important in treatments with dose escalation (Mohamad et al 2017, Malouff et al 2020.…”

Section: Introductionmentioning

confidence: 99%

Preliminary tests of dosimetric quality and projected therapeutic outcomes of multi-phase 4D radiotherapy with proton and carbon ion beams

et al. 2021

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Objective. The purpose of this study was to perform preliminary pre-clinical tests to compare the dosimetric quality of two approaches to treating moving tumors with ion beams: synchronously delivering the beam with the motion of a moving planning target volume (PTV) using the recently developed multi-phase 4D dose delivery (MP4D) approach, and asynchronously delivering the ion beam to a motion-encompassing internal tumor volume (ITV) combined with rescanning. Approach. We created 4D optimized treatment plans with proton and carbon ion beams for two patients who had previously received treatment for non-small cell lung cancer. For each patient, we created several treatment plans, using approaches with and without motion mitigation: MP4D, ITV with rescanning, static deliveries to a stationary PTV, and deliveries to a moving tumor without motion compensation. Two sets of plans were optimized with margins or robust uncertainty scenarios. Each treatment plan was delivered using a recently-developed motion-synchronized dose delivery system (M-DDS); dose distributions in water were compared to measurements using gamma index analysis to confirm the accuracy of the calculations. Reconstructed dose distributions on the patient CT were analyzed to assess the dosimetric quality of the deliveries (conformity, uniformity, tumor coverage, and extent of hotspots). Main results. Gamma index analysis pass rates confirmed the accuracy of dose calculations. Dose coverage was >95% for all static and MP4D treatments. The best conformity and the lowest lung doses were achieved with MP4D deliveries. Robust optimization led to higher lung doses compared to conventional optimization for ITV deliveries, but not for MP4D deliveries. Significance. We compared dosimetric quality for two approaches to treating moving tumors with ion beams. Our findings suggest that the MP4D approach, using an M-DDS, provides conformal motion mitigation, with full target coverage and lower OAR doses.

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Comparison of photon volumetric modulated arc therapy, intensity-modulated proton therapy, and intensity-modulated carbon ion therapy for delivery of hypo-fractionated thoracic radiotherapy

Cited by 6 publications

References 48 publications

Dosimetric evaluation of 4D‐CBCT reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for carbon ion therapy of lung cancer

Dosimetric evaluation of 4D‐CBCT reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for carbon ion therapy of lung cancer

Clinical Outcomes of Intensity-modulated Carbon-ion Radiotherapy for Bone and Soft Tissue Tumors

Preliminary tests of dosimetric quality and projected therapeutic outcomes of multi-phase 4D radiotherapy with proton and carbon ion beams

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