Dosimetric Evaluation of Beam-specific PTV and Worst-case Optimization Methods for Liver Proton Therapy

Overview

Journal In Vivo

Specialty Oncology

Date 2024 Oct 30

PMID 39477417

Authors

Akihiro Yamano

Tatsuya Inoue

Shintaro Shiba

Takahiro Shimo

Masashi Yamanaka

Ryosuke Shirata

Kazuki Matsumoto

Takayuki Yagihashi

Koichi Tokuuye

Weishan Chang

Affiliations

Soon will be listed here.

Abstract

Background/aim: In spot-scanning proton therapy, intra-fractional anatomical changes by organ movement can lead to deterioration in dose distribution due to beam range variation. To explore a more robust treatment planning method, this study evaluated the dosimetric characteristics and robustness of two proton therapy planning methods for liver cancer.

Patients And Methods: Two- or three-field treatment plans were created for 11 patients with hepatocellular carcinoma or metastatic liver cancer using a single-field uniform dose (SFUD) technique. The plans were optimized using either beam-specific planning target volume (BSPTV) or worst-case optimization (WCO). The target coverage for the gross tumor volume (GTV), planning target volume (PTV), and organs at risk (OAR) parameters related to toxicity were calculated from the perturbed dose distributions, considering setup and range uncertainties. Statistical analyses of the BSPTV and WCO plans were performed using the Wilcoxon signed-rank sum test (p<0.05). The calculation times for a single optimization process were also recorded and compared.

Results: The robustness of the WCO plans in the worst-case scenario was significantly higher than that of the BSPTV plan in terms of GTV target coverage, prevention of maximum dose increase to the gastrointestinal tract, and the dose received by normal liver regions. However, there were no significant differences in PTV, and the calculation time required to create the WCO plan was considerably longer.

Conclusion: In SFUD proton therapy for liver cancer, the WCO plans required a longer optimization time but exhibited superior robustness in GTV coverage and sparing of OARs.

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