Impact of Multiple Beams on Plan Quality, Linear Energy Transfer Distribution, and Plan Robustness of Intensity Modulated Proton Therapy for Lung Cancer.
机构：[1]Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, P. R. China[2]University of Chinese Academy of Sciences, Beijing 100049, P. R. China[3]RaySearch China, Shanghai 200120, P. R. China[4]Shanghai Advanced Research Institute, Chinese Academy Sciences, Shanghai 201210, P. R. China[5]Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China四川大学华西医院[6]Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P. R. China北京大学深圳医院深圳市康宁医院深圳市南山区人民医院深圳医学信息中心中国医学科学院肿瘤医院深圳医院[7]Department of Radiation and Medical Oncology, The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou 32500, P. R. China
The increase of proton beam number might provide higher degrees of freedom in the optimization of intensity-modulated proton therapy planning. In this study, we aimed to quantitatively explore the potential benefits of the increased beam number, including dose volume histogram (DVH), linear energy transfer volume histogram, and DVH bandwidth metrics. Twelve patients with lung cancer are retrospectively selected. Four plans were created based on internal target volume (ITV) robust optimization for each patient using the RayStation treatment planning system. Four plans were generated using different numbers (three, five, seven, and nine) of evenly separated coplanar beams. The three-beam plan was considered as the reference plan. Biologically equivalent doses were calculated using both constant relative biological effectiveness (RBE) and variable RBE models, respectively. To evaluate plan quality, DVH metrics in the target [ITV: D2%, CI, HI] and organs-at-risk [Lung: V5Gy[RBE], V20Gy[RBE], V30Gy[RBE]; Heart D2%; Spinal cord D2%] were calculated using both RBE models. To evaluate LET distributions, LET volume histogram metrics [ITV LETmean and LET2%; Lung LETmean and LET2%; Heart LET2%; Spinal cord LET2%] were quantified. To evaluate plan robustness, the metrics using DVH bandwidth [ITV: D2%, D99%; Lung: V5Gy[RBE], V20Gy[RBE], V30Gy[RBE]; Heart D2%; Spinal cord D2%] were also reported. For plan quality, the increase of proton beam number resulted in fewer target hot spots, improved target dose conformity, improved target dose homogeneity, lower median-dose lung volume, and fewer hot spots in spinal cord. As to LET distributions, target mean LET increased significantly as the beam number increased to seven or more. Lung LET hot spots were significantly reduced with the increase of proton beams. With respect to plan robustness, the robustness of target dose coverage, target hot spots, and low-dose lung volume were improved, while the robustness of heart hot spots became worse as the beam number increased to nine. The robustness of cord hot spots became worse using five and seven beams compared to that using three beams. As the proton beam number increased, plan quality and LET distributions were comparable or significantly improved. The robustness of target dose coverage, target dose hot spots, and low-dose lung volume were significantly improved.
基金：
Financial support from Sanming Project of Medicine in Shenzhen (No.SZSM201612063) is acknowledged. We thank Mr. Jie Shan and Dr. Wei Liu for the discussion. This work is dedicated to the memory of Dr. Nongjian Tao (1963–2020).
第一作者机构：[1]Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, P. R. China[2]University of Chinese Academy of Sciences, Beijing 100049, P. R. China
通讯作者：
通讯机构：[6]Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P. R. China[*1]Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P. R. China
推荐引用方式(GB/T 7714)：
Haijiao Shang,Yuehu Pu,Zhiling Chen,et al.Impact of Multiple Beams on Plan Quality, Linear Energy Transfer Distribution, and Plan Robustness of Intensity Modulated Proton Therapy for Lung Cancer.[J].ACS SENSORS.2021,6(2):408-417.doi:10.1021/acssensors.0c01879.
APA：
Haijiao Shang,Yuehu Pu,Zhiling Chen,Xuetao Wang,Cuiyun Yuan...&Chenbin Liu.(2021).Impact of Multiple Beams on Plan Quality, Linear Energy Transfer Distribution, and Plan Robustness of Intensity Modulated Proton Therapy for Lung Cancer..ACS SENSORS,6,(2)
MLA：
Haijiao Shang,et al."Impact of Multiple Beams on Plan Quality, Linear Energy Transfer Distribution, and Plan Robustness of Intensity Modulated Proton Therapy for Lung Cancer.".ACS SENSORS 6..2(2021):408-417
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