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Impact of Multiple Beams on Plan Quality, Linear Energy Transfer Distribution, and Plan Robustness of Intensity Modulated Proton Therapy for Lung Cancer
ACS Sensors ( IF 8.2 ) Pub Date : 2020-10-30 , DOI: 10.1021/acssensors.0c01879 Haijiao Shang 1, 2, 3 , Yuehu Pu 1, 2 , Zhiling Chen 4 , Xuetao Wang 5 , Cuiyun Yuan 6 , Xiance Jin 7 , Chenbin Liu 6
ACS Sensors ( IF 8.2 ) Pub Date : 2020-10-30 , DOI: 10.1021/acssensors.0c01879 Haijiao Shang 1, 2, 3 , Yuehu Pu 1, 2 , Zhiling Chen 4 , Xuetao Wang 5 , Cuiyun Yuan 6 , Xiance Jin 7 , Chenbin Liu 6
Affiliation
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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.
中文翻译：
多光束对肺癌强度调制质子疗法的计划质量，线性能量转移分布和计划稳健性的影响
质子束数量的增加可能在强度调制质子治疗计划的优化中提供更高的自由度。在这项研究中，我们旨在定量研究增加束数的潜在好处，包括剂量体积直方图（DVH），线性能量转移体积直方图和DVH带宽指标。回顾性选择了十二名肺癌患者。使用RayStation治疗计划系统，针对每个患者，基于内部目标量（ITV）鲁棒优化创建了四个计划。使用不同数量（三个，五个，七个和九个）的均匀分离的共面光束生成了四个计划。三光束计划被视为参考计划。分别使用恒定相对生物学有效性（RBE）和可变RBE模型来计算生物等效剂量。要评估计划质量，请在目标[ITV：D 2％，CI，HI]和高危器官[肺：V 5Gy [RBE]，V 20Gy [RBE]，V 30Gy [RBE]；心D 2％；使用两种RBE模型计算脊髓D 2％ ]。要评估LET分布，请使用LET体积直方图指标[ITV LET平均值和LET 2％；肺LET均值和LET 2％ ; 心LET 2％；对脊髓LET 2％进行定量。为了评估计划的稳健性，使用DVH带宽的指标[ITV：D 2％，D 99％ ; 肺：V 5Gy [RBE]，V 20Gy [RBE]，V 30Gy [RBE] ; 心D 2％；脊髓D 2％]也有报道。对于计划质量，质子束数的增加导致更少的目标热点，改善的目标剂量一致性，改善的目标剂量同质性，更低的中剂量肺体积和更少的脊髓热点。关于LET分布，目标平均LET随着光束数增加到七个或更多而显着增加。随着质子束的增加，肺LET热点明显减少。关于计划的鲁棒性，目标剂量覆盖范围，目标热点和低剂量肺活量的鲁棒性得到了改善，而随着束数增加到9，心脏热点的鲁棒性变得更差。与使用三束光束相比，使用五束和七束光束的绳索热点的鲁棒性变得更差。随着质子束数的增加，计划质量和LET分布可比或显着改善。目标剂量覆盖范围，目标剂量热点和低剂量肺活量的鲁棒性得到了显着改善。
更新日期：2020-10-30
中文翻译：
多光束对肺癌强度调制质子疗法的计划质量，线性能量转移分布和计划稳健性的影响
质子束数量的增加可能在强度调制质子治疗计划的优化中提供更高的自由度。在这项研究中，我们旨在定量研究增加束数的潜在好处，包括剂量体积直方图（DVH），线性能量转移体积直方图和DVH带宽指标。回顾性选择了十二名肺癌患者。使用RayStation治疗计划系统，针对每个患者，基于内部目标量（ITV）鲁棒优化创建了四个计划。使用不同数量（三个，五个，七个和九个）的均匀分离的共面光束生成了四个计划。三光束计划被视为参考计划。分别使用恒定相对生物学有效性（RBE）和可变RBE模型来计算生物等效剂量。要评估计划质量，请在目标[ITV：D 2％，CI，HI]和高危器官[肺：V 5Gy [RBE]，V 20Gy [RBE]，V 30Gy [RBE]；心D 2％；使用两种RBE模型计算脊髓D 2％ ]。要评估LET分布，请使用LET体积直方图指标[ITV LET平均值和LET 2％；肺LET均值和LET 2％ ; 心LET 2％；对脊髓LET 2％进行定量。为了评估计划的稳健性，使用DVH带宽的指标[ITV：D 2％，D 99％ ; 肺：V 5Gy [RBE]，V 20Gy [RBE]，V 30Gy [RBE] ; 心D 2％；脊髓D 2％]也有报道。对于计划质量，质子束数的增加导致更少的目标热点，改善的目标剂量一致性，改善的目标剂量同质性，更低的中剂量肺体积和更少的脊髓热点。关于LET分布，目标平均LET随着光束数增加到七个或更多而显着增加。随着质子束的增加，肺LET热点明显减少。关于计划的鲁棒性，目标剂量覆盖范围，目标热点和低剂量肺活量的鲁棒性得到了改善，而随着束数增加到9，心脏热点的鲁棒性变得更差。与使用三束光束相比，使用五束和七束光束的绳索热点的鲁棒性变得更差。随着质子束数的增加，计划质量和LET分布可比或显着改善。目标剂量覆盖范围，目标剂量热点和低剂量肺活量的鲁棒性得到了显着改善。
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