Spot-scanned pancreatic stereotactic body proton therapy: A dosimetric feasibility and robustness study

Terence T. Sio; Kenneth W. Merrell; Chris J. Beltran; Jonathan B. Ashman; Kathleen A. Hoeft; Robert C. Miller; Thomas J. Whitaker; Stephanie K. Wurgler; Erik J. Tryggestad

doi:10.1016/j.ejmp.2015.12.009

Spot-scanned pancreatic stereotactic body proton therapy: A dosimetric feasibility and robustness study

Terence T. Sio, Kenneth W. Merrell, Chris J. Beltran, Jonathan B. Ashman, Kathleen A. Hoeft, Robert C. Miller, Thomas J. Whitaker, Stephanie K. Wurgler, Erik J. Tryggestad

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Purpose: We explored the dosimetric potential of spot-scanned stereotactic body proton therapy (SBPT) for pancreatic cancer. Methods: We compared SBPT to stereotactic body intensity-modulated radiotherapy (SB-IMRT) in 10 patients. We evaluated 3 variables in SBPT planning: (1) 4 and 6 mm spot size; (2) single vs. multi-field optimization (SFO vs. MFO); and (3) optimization target volume (OTV) expansion. Robustness analysis was performed with unidirectional isocenter shifts of ±3 mm in x, y, and z and ±3% stopping power uncertainties. Results: SBPT plans had lower V_10Gy for the stomach and small and large bowels. Under static robustness, a 5 mm OTV and SFO-6 mm spot size represented the best compromise between target and normal structure. A 4-mm spot-size and 3 mm OTV resulted in significant target underdosing with deformable dose accumulation analysis. Conclusions: This study provides a critical basis for clinical translation of spot size, optimization technique, and OTV expansion for pancreatic SBPT.

Original language	English (US)
Pages (from-to)	331-342
Number of pages	12
Journal	Physica Medica
Volume	32
Issue number	2
DOIs	https://doi.org/10.1016/j.ejmp.2015.12.009
State	Published - Feb 1 2016

Keywords

Intensity-modulated radiation therapy
Pancreatic cancer
Proton plan robustness
Spot-scanned proton therapy
Stereotactic body proton therapy
Stereotactic body radiation therapy

ASJC Scopus subject areas

Biophysics
Radiology Nuclear Medicine and imaging
General Physics and Astronomy

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10.1016/j.ejmp.2015.12.009

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title = "Spot-scanned pancreatic stereotactic body proton therapy: A dosimetric feasibility and robustness study",

abstract = "Purpose: We explored the dosimetric potential of spot-scanned stereotactic body proton therapy (SBPT) for pancreatic cancer. Methods: We compared SBPT to stereotactic body intensity-modulated radiotherapy (SB-IMRT) in 10 patients. We evaluated 3 variables in SBPT planning: (1) 4 and 6 mm spot size; (2) single vs. multi-field optimization (SFO vs. MFO); and (3) optimization target volume (OTV) expansion. Robustness analysis was performed with unidirectional isocenter shifts of ±3 mm in x, y, and z and ±3% stopping power uncertainties. Results: SBPT plans had lower V10Gy for the stomach and small and large bowels. Under static robustness, a 5 mm OTV and SFO-6 mm spot size represented the best compromise between target and normal structure. A 4-mm spot-size and 3 mm OTV resulted in significant target underdosing with deformable dose accumulation analysis. Conclusions: This study provides a critical basis for clinical translation of spot size, optimization technique, and OTV expansion for pancreatic SBPT.",

keywords = "Intensity-modulated radiation therapy, Pancreatic cancer, Proton plan robustness, Spot-scanned proton therapy, Stereotactic body proton therapy, Stereotactic body radiation therapy",

author = "Sio, {Terence T.} and Merrell, {Kenneth W.} and Beltran, {Chris J.} and Ashman, {Jonathan B.} and Hoeft, {Kathleen A.} and Miller, {Robert C.} and Whitaker, {Thomas J.} and Wurgler, {Stephanie K.} and Tryggestad, {Erik J.}",

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language = "English (US)",

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T1 - Spot-scanned pancreatic stereotactic body proton therapy

T2 - A dosimetric feasibility and robustness study

AU - Sio, Terence T.

AU - Merrell, Kenneth W.

AU - Beltran, Chris J.

AU - Ashman, Jonathan B.

AU - Hoeft, Kathleen A.

AU - Miller, Robert C.

AU - Whitaker, Thomas J.

AU - Wurgler, Stephanie K.

AU - Tryggestad, Erik J.

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N2 - Purpose: We explored the dosimetric potential of spot-scanned stereotactic body proton therapy (SBPT) for pancreatic cancer. Methods: We compared SBPT to stereotactic body intensity-modulated radiotherapy (SB-IMRT) in 10 patients. We evaluated 3 variables in SBPT planning: (1) 4 and 6 mm spot size; (2) single vs. multi-field optimization (SFO vs. MFO); and (3) optimization target volume (OTV) expansion. Robustness analysis was performed with unidirectional isocenter shifts of ±3 mm in x, y, and z and ±3% stopping power uncertainties. Results: SBPT plans had lower V10Gy for the stomach and small and large bowels. Under static robustness, a 5 mm OTV and SFO-6 mm spot size represented the best compromise between target and normal structure. A 4-mm spot-size and 3 mm OTV resulted in significant target underdosing with deformable dose accumulation analysis. Conclusions: This study provides a critical basis for clinical translation of spot size, optimization technique, and OTV expansion for pancreatic SBPT.

AB - Purpose: We explored the dosimetric potential of spot-scanned stereotactic body proton therapy (SBPT) for pancreatic cancer. Methods: We compared SBPT to stereotactic body intensity-modulated radiotherapy (SB-IMRT) in 10 patients. We evaluated 3 variables in SBPT planning: (1) 4 and 6 mm spot size; (2) single vs. multi-field optimization (SFO vs. MFO); and (3) optimization target volume (OTV) expansion. Robustness analysis was performed with unidirectional isocenter shifts of ±3 mm in x, y, and z and ±3% stopping power uncertainties. Results: SBPT plans had lower V10Gy for the stomach and small and large bowels. Under static robustness, a 5 mm OTV and SFO-6 mm spot size represented the best compromise between target and normal structure. A 4-mm spot-size and 3 mm OTV resulted in significant target underdosing with deformable dose accumulation analysis. Conclusions: This study provides a critical basis for clinical translation of spot size, optimization technique, and OTV expansion for pancreatic SBPT.

KW - Intensity-modulated radiation therapy

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KW - Proton plan robustness

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KW - Stereotactic body radiation therapy

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Spot-scanned pancreatic stereotactic body proton therapy: A dosimetric feasibility and robustness study

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Keywords

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