Dose- and LET-painting with particle therapy

Bassler, Niels; Jäkel, Oliver; Søndergaard, Claus S.; Petersen, J.

doi:10.3109/0284186x.2010.510640

Cited by 135 publications

(119 citation statements)

References 27 publications

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“…Good understanding of the dependency of RBE on the LET parameter and therefore the beam modulation may lead to further optimization of LET painting as effective tumor treatment modality (18,19).…”

Section: Introductionmentioning

confidence: 99%

Relative Biological Effectiveness Variation Along Monoenergetic and Modulated Bragg Peaks of a 62-MeV Therapeutic Proton Beam: A Preclinical Assessment

Chaudhary

Marshall

Perozziello

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

205

194

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SummaryBiological optimization of proton therapy critically depends upon detailed evaluation of RBE variations along Bragg curve. Clinically accepted RBE value of 1.1 is an oversimplification, which disregards the steep rise of LET at the distal end of the SOBP. We observed significant cell killing RBE variations dependent upon beam modulation, intrinsic radiosensitivity and LET in agreement with the LEM predicted values indicating dose averaged LET as suitable parameter for biological effectiveness. Data have also been used to validate a RBE parameterized model. Conclusions:The predicted biological dose delivered to a tumor region based on the variable RBE inferred from the data, varies significantly with respect to the clinically used constant RBE of 1.1. The significant RBE increase at the distal end suggests also a potential to enhance optimization of treatment modalities such as LET painting of hypoxic tumors. The study highlights the limitation of adoption of a constant RBE for proton therapy and suggests approaches for fast implementation of RBE models in treatment planning.

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Section: Introductionmentioning

confidence: 99%

Relative Biological Effectiveness Variation Along Monoenergetic and Modulated Bragg Peaks of a 62-MeV Therapeutic Proton Beam: A Preclinical Assessment

Chaudhary

Marshall

Perozziello

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

205

194

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“…scanning repetitively within one fraction [8]. A number of repainting schemes have been investigated previously [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Proton pencil beam scanning for mediastinal lymphoma: treatment planning and robustness assessment

et al. 2016

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Background: Modern radiotherapy (RT) for lymphoma is highly personalized. While advanced imaging is largely employed to define limited treatment volumes, the use of proton pencil beam scanning (PBS) for highly conformal lymphoma RT is still in its infancy. Here, we assess the dosimetric benefits and feasibility of PBS for mediastinal lymphoma (ML). Materials and methods: Ten patients were planned using PBS for involved-site RT. The initial plans were calculated on the average four-dimensional computed tomography (4D-CT). PBS plans were compared with 3D conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and proton double scattering (DS). In order to evaluate the feasibility of PBS and the plan robustness against interand intra-fractional uncertainties, the 4D dose was calculated on initial and verification CTs. The deviation of planned dose from delivered dose was measured. The same proton beamline was used for all patients, while another beamline with larger spots was employed for patients with large motion perpendicular to the beam. Results: PBS provided the lowest mean lung dose (MLD) and mean heart dose (MHD) for all patients in comparison with 3D-CRT, IMRT, and DS. For eight patients, internal target volume (ITV) D 98% was degraded by <3%; and the MLD and MHD deviated by <10% of prescription over the course of treatment when the PBS field was painted twice in each session. For one patient with target motion perpendicular to the beam (>5 mm), the degradation of ITV D 98% was 9%, which was effectively mitigated by employing large spots. One patient exhibited large dose degradation due to pericardial effusion, which required replanning across all modalities. Conclusions: This study demonstrates that PBS plans significantly reduce MLD and MHD relative to 3D-CRT, IMRT, and DS and identifies requirements for robust free-breathing ML PBS treatments, showing that PBS plan robustness can be maintained with repainting and/or large spots.

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“…In principle this could be further extrapolated into LET painting by numbers, whereby RBE is assigned on a voxel-by-voxel basis according to the measured level of biological risk. Bassler et al [73] modelled how treatment planning based on simultaneous dose and LET optimisation has a potential to achieve higher tumour control and reduce normal tissue complication probability. Given the paucity of high-LET treatment units, this treatment paradigm is still a long way off.…”

Section: Particle Therapy For Biological Optimisationmentioning

confidence: 99%

Functional Radiotherapy Targeting using Focused Dose Escalation

Alonzi

2015

Clinical Oncology

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Dose- and LET-painting with particle therapy

Cited by 135 publications

References 27 publications

Relative Biological Effectiveness Variation Along Monoenergetic and Modulated Bragg Peaks of a 62-MeV Therapeutic Proton Beam: A Preclinical Assessment

Relative Biological Effectiveness Variation Along Monoenergetic and Modulated Bragg Peaks of a 62-MeV Therapeutic Proton Beam: A Preclinical Assessment

Proton pencil beam scanning for mediastinal lymphoma: treatment planning and robustness assessment

Functional Radiotherapy Targeting using Focused Dose Escalation

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