The purpose of this study was to grasp current potential problems of dose error in intensity-modulated proton therapy (IMPT) plans. We were interested in dose differences of the Varian Eclipse treatment planning syste...The purpose of this study was to grasp current potential problems of dose error in intensity-modulated proton therapy (IMPT) plans. We were interested in dose differences of the Varian Eclipse treatment planning system (TPS) and the fast dose calculation method (FDC) for single-field optimization (SFO) and multi-field optimization (MFO) IMPT plans. In addition, because some authors have reported dosimetric benefit of a proton arc therapy with ultimate multi-fields in recent years, we wanted to evaluate how the number of fields and beam angles affect the differences for IMPT plans. Therefore, for one brain cancer patient with a large heterogeneity, SFO and MFO IMPT plans with various multi-angle beams were planned by the TPS. Dose distributions for each IMPT plan were calculated by both the TPS’s conventional pencil beam algorithm and the FDC. The dosimetric parameters were compared between the two algorithms. The TPS overestimated 400 - 500 cGy (RBE) for minimum dose to the CTV relative to the dose calculated by the FDC. These differences indicate clinically relevant effect on clinical results. In addition, we observed that the maximum difference in dose calculated between the TPS and the FDC was about 900 cGy (RBE) for the right optic nerve, and this quantity also has a possibility to have a clinical effect. The major difference was not seen in calculations for SFO IMPT planning and those for MFO IMPT planning. Differences between the TPS and the FDC in SFO and MFO IMPT plans depend strongly on beam arrangement and the presence of a heterogeneous body. We advocate use of a Monte Carlo method in proton treatment planning to deliver the most precise proton dose in IMPT.展开更多
IMPT plans with various multi-angle beams were planned by the Varian Eclipse treatment planning system for one case of brain cancer. Dose distributions for each plan, along with the associated linear energy transfer d...IMPT plans with various multi-angle beams were planned by the Varian Eclipse treatment planning system for one case of brain cancer. Dose distributions for each plan, along with the associated linear energy transfer distributions, were recomputed using an in-house fast Monte Carlo dose calculator with a FRBE of 1.1 or with a previously published VRBE model. We then compared dosimetric parameters obtained by the VRBE with those obtained by the FRBE. Biological doses obtained by the VRBE for the clinical target volume in all plans were 1% - 2% larger than those obtained by the FRBE. The minimum dose obtained by the VRBE for the right optic nerve in the MFO IMPT with 4 fields was 70% larger than that obtained by the FRBE, but the difference was only 18.1 cGy (RBE). The difference in maximum dose for the right optic nerve in the MFO IMPT with 5 fields was less than 10.4%, but the difference was 131.8 cGy (RBE). The mean difference in maximum dose was less than 2% for all other organs at risk. We found that biological dose with the FRBE had any dose errors in IMPT with various multi-angle beams.展开更多
文摘The purpose of this study was to grasp current potential problems of dose error in intensity-modulated proton therapy (IMPT) plans. We were interested in dose differences of the Varian Eclipse treatment planning system (TPS) and the fast dose calculation method (FDC) for single-field optimization (SFO) and multi-field optimization (MFO) IMPT plans. In addition, because some authors have reported dosimetric benefit of a proton arc therapy with ultimate multi-fields in recent years, we wanted to evaluate how the number of fields and beam angles affect the differences for IMPT plans. Therefore, for one brain cancer patient with a large heterogeneity, SFO and MFO IMPT plans with various multi-angle beams were planned by the TPS. Dose distributions for each IMPT plan were calculated by both the TPS’s conventional pencil beam algorithm and the FDC. The dosimetric parameters were compared between the two algorithms. The TPS overestimated 400 - 500 cGy (RBE) for minimum dose to the CTV relative to the dose calculated by the FDC. These differences indicate clinically relevant effect on clinical results. In addition, we observed that the maximum difference in dose calculated between the TPS and the FDC was about 900 cGy (RBE) for the right optic nerve, and this quantity also has a possibility to have a clinical effect. The major difference was not seen in calculations for SFO IMPT planning and those for MFO IMPT planning. Differences between the TPS and the FDC in SFO and MFO IMPT plans depend strongly on beam arrangement and the presence of a heterogeneous body. We advocate use of a Monte Carlo method in proton treatment planning to deliver the most precise proton dose in IMPT.
文摘IMPT plans with various multi-angle beams were planned by the Varian Eclipse treatment planning system for one case of brain cancer. Dose distributions for each plan, along with the associated linear energy transfer distributions, were recomputed using an in-house fast Monte Carlo dose calculator with a FRBE of 1.1 or with a previously published VRBE model. We then compared dosimetric parameters obtained by the VRBE with those obtained by the FRBE. Biological doses obtained by the VRBE for the clinical target volume in all plans were 1% - 2% larger than those obtained by the FRBE. The minimum dose obtained by the VRBE for the right optic nerve in the MFO IMPT with 4 fields was 70% larger than that obtained by the FRBE, but the difference was only 18.1 cGy (RBE). The difference in maximum dose for the right optic nerve in the MFO IMPT with 5 fields was less than 10.4%, but the difference was 131.8 cGy (RBE). The mean difference in maximum dose was less than 2% for all other organs at risk. We found that biological dose with the FRBE had any dose errors in IMPT with various multi-angle beams.
