Benchmarking of a treatment planning system for spot scanning proton therapy: Comparison and analysis of robustness to setup errors of photon IMRT and proton SFUD treatment plans of base of skull meningioma

Harding, R.; Trnková, Petra; Weston, S.; Lilley, J.; Thompson, Christopher; Short, Susan; Loughrey, Carmel; Cosgrove, V.P.; Lomax, Anthony; Thwaites, David

doi:10.1118/1.4897571

Cited by 10 publications

(9 citation statements)

References 57 publications

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“…Such methods are typically based upon pencil beam algorithms (Petti 1992, Russell et al 1995, Hong et al 1996, Deasy 1998, Schneider et al 1998, Schaffner et al 1999, Szymanowski and Oelfke 2002, Taylor et al 2017 which perform well in homogeneous media, however they become less accurate when significant inhomogeneities are present, for instance in patients with tumors in the thoracic, head-and-neck, or lung regions (Sawakuchi et al 2008, Paganetti 2012, Yang et al 2012, Bueno et al 2013, Schuemann et al 2014. Monte Carlo (MC) methods, like Geant4 (Agostinelli et al 2003, Allison et al 2006, Fluka (Ferrari et al 2005, Böhlen et al 2014, MCNPX (Waters et al, 2005), etc., which can precisely describe particle transport through matter, are considered the most accurate methods for radiotherapy dose calculations (Schaffner et al 1999, Koch et al 2008, Taddei et al 2009, Harding et al 2014, Giantsoudi et al 2015, Dedes et al 2015. To overcome the limitation of long computing time for traditional MC codes, a variety of fast MC methods have been developed (Jia et al 2012, Giantsoudi et al 2015.…”

Section: Introductionmentioning

confidence: 99%

Automatic phase space generation for Monte Carlo calculations of intensity modulated particle therapy

Wang

Zhu

Bai

et al. 2020

Biomed. Phys. Eng. Express

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Monte Carlo (MC) is generally considered as the most accurate dose calculation tool for particle therapy. However, a proper description of the beam particles kinematics is a necessary input for a realistic simulation. Such a description can be stored in phase space (PS) files for different beam energies. A PS file contains kinetic information such as energies, positions and travelling directions for particles traversing a plane perpendicular to the beam direction. The accuracy of PS files play a critical role in the performance of the MC method for dose calculations. A PS file can be generated with a set of parameters describing analytically the beam kinematics. However, determining such parameters can be tedious and time consuming. Thus, we have developed an algorithm to obtain those parameters automatically and efficiently. In this paper, we present such an algorithm and compare dose calculations using PS automatically generated for the Shanghai Proton and Heavy Ion Center (SPHIC) with measurements. The gamma-index for comparing calculated depth dose distributions (DDD) with measurements are above 96.0% with criterion 0.6%/0.6 mm. For each single energy, the mean difference percentage between calculated lateral spot sizes at 5 different depths and measurements are below 3.5%.

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Section: Introductionmentioning

confidence: 99%

Automatic phase space generation for Monte Carlo calculations of intensity modulated particle therapy

Wang

Zhu

Bai

et al. 2020

Biomed. Phys. Eng. Express

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“…Currently, in both IMRT and IMPT, these uncertainties are commonly taken into account by expanding the clinical target volume (CTV) to the planning target volume (PTV) to ensure adequate dose coverage of the CTV [ 12 , 13 ]. However, the physical properties of protons can conflict with this traditional CTV-PTV concept, as errors can result in centralized target volume under-dosage, ultimately risking tumor recurrence [ 11 , 14 – 19 ]. Therefore, proton therapy requires a different approach to achieve robustness, which refers to the correspondence of planned and actual dose distributions in presence of errors and unanticipated changes.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, all treatment plans were generated using the same treatment planning system. This allows comparison of the different modalities without introducing biases related to the use of different planning systems [ 19 ]. Since the number of fields in robust planning might influence the dose to OARs [ 18 ] or the robustness of the IMPT plans [ 11 , 14 , 17 ], this aspect was also included in our study.…”

Section: Introductionmentioning

confidence: 99%

Robust Intensity Modulated Proton Therapy (IMPT) Increases Estimated Clinical Benefit in Head and Neck Cancer Patients

et al. 2016

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PurposeTo compare the clinical benefit of robust optimized Intensity Modulated Proton Therapy (minimax IMPT) with current photon Intensity Modulated Radiation Therapy (IMRT) and PTV-based IMPT for head and neck cancer (HNC) patients. The clinical benefit is quantified in terms of both Normal Tissue Complication Probability (NTCP) and target coverage in the case of setup and range errors.Methods and MaterialsFor 10 HNC patients, PTV-based IMRT (7 fields), minimax and PTV-based IMPT (2, 3, 4, 5 and 7 fields) plans were tested on robustness. Robust optimized plans differed from PTV-based plans in that they target the CTV and penalize possible error scenarios, instead of using the static isotropic CTV-PTV margin. Perturbed dose distributions of all plans were acquired by simulating in total 8060 setup (±3.5 mm) and range error (±3%) combinations. NTCP models for xerostomia and dysphagia were used to predict the clinical benefit of IMPT versus IMRT.ResultsThe robustness criterion was met in the IMRT and minimax IMPT plans in all error scenarios, but this was only the case in 1 of 40 PTV-based IMPT plans. Seven (out of 10) patients had relatively large NTCP reductions in minimax IMPT plans compared to IMRT. For these patients, xerostomia and dysphagia NTCP values were reduced by 17.0% (95% CI; 13.0–21.1) and 8.1% (95% CI; 4.9–11.2) on average with minimax IMPT. Increasing the number of fields did not contribute to plan robustness, but improved organ sparing.ConclusionsThe estimated clinical benefit in terms of NTCP of robust optimized (minimax) IMPT is greater than that of IMRT and PTV-based IMPT in HNC patients. Furthermore, the target coverage of minimax IMPT plans in the presence of errors was comparable to IMRT plans.

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“…1,[4][5][6][7][8] As Eclipse™'s module for protons was only recently released, not much literature exists comparing it to other TPSs. As for PSI-Plan, it was used before to benchmark XiO ® photon plans, 17 but never against another TPS for proton planning.…”

Section: Discussionmentioning

confidence: 99%

Benchmarking a commercial proton therapy solution: The Paul Scherrer Institut experience

Rosas

Belosi

Bizzocchi³

et al. 2020

The British Journal of Radiology

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Objective: For the past 20 years, Paul Scherrer Institut (PSI) has treated more than 1500 patients with deep-seated tumors using PSI-Plan, an in-house developed treatment planning system (TPS) used for proton beam scanning proton therapy, in combination with its home-built gantries. The goal of the present work is to benchmark the performance of a new TPS/Gantry system for proton therapy centers which have established already a baseline standard of care. Methods and materials: A total of 31 cases (=52 plans) distributed around 7 anatomical sites and 12 indications were randomly selected and re-planned using Eclipse™. The resulting plans were compared with plans formerly optimized in PSI-Plan, in terms of target coverage, plan quality, organ-at-risk (OAR) sparing and number of delivered pencil beams. Results: Our results show an improvement on target coverage and homogeneity when using Eclipse™ while PSI-Plan showed superior plan conformity. As for OAR sparing, both TPS achieved the clinical constraints. The number of pencil beams required per plan was on average 3.4 times higher for PSI-Plan. Conclusion: Both systems showed a good capacity to produce satisfactory plans, with Eclipse™ being able to achieve better target coverage and plan homogeneity without compromising OARs. Advances in knowledge: A benchmark between a clinically tested and validated system with a commercial solution is of interest for emerging proton therapy, equipped with commercial systems and no previous experience with proton beam scanning.

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Benchmarking of a treatment planning system for spot scanning proton therapy: Comparison and analysis of robustness to setup errors of photon IMRT and proton SFUD treatment plans of base of skull meningioma

Abstract: Robustness analysis is a critical part of plan evaluation when comparing IMRT plans with spot scanned proton therapy plans.

Cited by 10 publications

References 57 publications

Automatic phase space generation for Monte Carlo calculations of intensity modulated particle therapy

Automatic phase space generation for Monte Carlo calculations of intensity modulated particle therapy

Robust Intensity Modulated Proton Therapy (IMPT) Increases Estimated Clinical Benefit in Head and Neck Cancer Patients

Benchmarking a commercial proton therapy solution: The Paul Scherrer Institut experience

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