Improved healthy tissue sparing in proton therapy of lung tumors using statistically sound robust optimization and evaluation

Badiu, Vlad; Souris, Kevin; Buti, Gregory; Villarroel, Elena Borderías; Lambrecht, Maarten; Sterpin, Edmond

doi:10.1016/j.ejmp.2022.02.018

Cited by 11 publications

(3 citation statements)

References 24 publications

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“…Recent studies have reported that using a limited set of relevant uncertainty scenarios in the robust optimization process can reduce the planning time without compromising plan robustness and OAR sparing in proton therapy. 41,42 This method might be able to accelerate the calculation process in tomotherapy planning. Another limitation is that plan robustness for setup error and anatomical changes was independently evaluated.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of robust optimization against geometric uncertainties in TomoHelical planning for prostate cancer

Yagihashi

Inoue

Nagata

et al. 2022

J Applied Clin Med Phys

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Background Geometrical uncertainties in patients can severely affect the quality of radiotherapy. Purpose We evaluated the dosimetric efficacy of robust optimization for helical intensity‐modulated radiotherapy (IMRT) planning in the presence of patient setup uncertainty and anatomical changes. Methods Two helical IMRT plans for 10 patients with localized prostate cancer were created using either minimax robust optimization (robust plan) or a conventional planning target volume (PTV) margin approach (PTV plan). Plan robustness was evaluated by creating perturbed dose plans with setup uncertainty from isocenter shifts and anatomical changes due to organ variation. The magnitudes of the geometrical uncertainties were based on the patient setup uncertainty considered during robust optimization, which was identical to the PTV margin. The homogeneity index, and target coverage (TC, defined as the V100% of the clinical target volume), and organs at risk (OAR; rectum and bladder) doses were analyzed for all nominal and perturbed plans. A statistical t ‐test was performed to evaluate the differences between the robust and PTV plans. Results Comparison of the nominal plans showed that the robust plans had lower OAR doses and a worse homogeneity index and TC than the PTV plans. The evaluations of robustness that considered setup errors more than the PTV margin demonstrated that the worst‐case perturbed scenarios for robust plans had significantly higher TC while maintaining lower OAR doses. However, when anatomical changes were considered, improvement in TC from robust optimization was not observed in the worst‐case perturbed plans. Conclusions For helical IMRT planning in localized prostate cancer, robust optimization provides benefits over PTV margin–based planning, including better OAR sparing, and increased robustness against systematic patient‐setup errors.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of robust optimization against geometric uncertainties in TomoHelical planning for prostate cancer

Yagihashi

Inoue

Nagata

et al. 2022

J Applied Clin Med Phys

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“…respiration, cardiac activity, bladder filling) that occur in the beam path can have a much greater impact on the spatial dose distribution, resulting in substantially increased doses to OARs or reduced target dose coverage. To mitigate these anatomic changes and motions, development and application of robust optimization methods ( 78 ), tracking/gating techniques or breath hold methods ( 79 , 80 ), in-room/real time image guidance (e.g. 4D-CT, cone-beam CT, MRI, optical surface monitoring system (OSMS)) ( 81 ) and in vivo range verification (e.g.…”

Section: Discussionmentioning

confidence: 99%

Proton versus photon radiation therapy: A clinical review

et al. 2023

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While proton radiation therapy offers substantially better dose distribution characteristics than photon radiation therapy in certain clinical applications, data demonstrating a quantifiable clinical advantage is still needed for many treatment sites. Unfortunately, the number of patients treated with proton radiation therapy is still comparatively small, in some part due to the lack of evidence of clear benefits over lower-cost photon-based treatments. This review is designed to present the comparative clinical outcomes between proton and photon therapies, and to provide an overview of the current state of knowledge regarding the effectiveness of proton radiation therapy.

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“…These have been studied in this context using computer simulations [20] and phantoms [21,22] with the clinical implications being reviewed as well [23]. The incorporation of scenarios for uncertainties has been investigated by sampling values based on isoprobability hypersurfaces [24].…”

Section: Introductionmentioning

confidence: 99%

Dosimetric Robustness of Lung Tumor Photon Radiotherapy Evaluated From Multiple Event Ct Imaging

Olofsson¹,

Wikström²,

Flejmer³

et al. 2022

Physica Medica

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Improved healthy tissue sparing in proton therapy of lung tumors using statistically sound robust optimization and evaluation

Cited by 11 publications

References 24 publications

Effectiveness of robust optimization against geometric uncertainties in TomoHelical planning for prostate cancer

Effectiveness of robust optimization against geometric uncertainties in TomoHelical planning for prostate cancer

Proton versus photon radiation therapy: A clinical review

Dosimetric Robustness of Lung Tumor Photon Radiotherapy Evaluated From Multiple Event Ct Imaging

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