Carbon Ion Pencil Beam Scanning Treatment With Gated Markerless Tumor Tracking: An Analysis of Positional Accuracy

Mori, Shinichiro; Karube, Masataka; Shirai, Tomoyuki; Yasuda, Sadatoshi; Yamamoto, Nariyuki; Yamada, Shigehito; Tsuji, Hidenori; Kamada, T.

doi:10.1016/j.ijrobp.2016.06.2191

Cited by 20 publications

(28 citation statements)

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“…Furthermore, gating could improve the target coverage, where the planned dose was not met. Gating, together with rescanning, has already been successfully implemented clinically for active beam scanning [Rossi, 2016, Mori et al, 2016 and it might be essential to use it in hypo-fractionated treatment of moving tumors [Richter et al, 2014].…”

Section: Summary and Discussionmentioning

confidence: 99%

“…Tumors in the abdomen region (liver and pancreas tumors) with were already successfully treated scanned ion beams at HIT, Heidelberg (Germany) and CNAO, Pavia (Italy) [Habermehl et al, 2013, Rossi, 2016 and first lung cancer patients are being treated at NIRS, Chiba (Japan) [Mori et al, 2016]. Studies on impact of scanned ion beams on lung cancer treatment are thus warranted, so that eligible patients can be identified.…”

Section: Motivationmentioning

confidence: 99%

“…Nevertheless, further studies are warranted, possibly using advanced moving phantoms for an experimental validation [Perrin et al, 2014] and finally also clinical trials. First patients are being treated in thoracic and abdominal regions with an active beam scanning at the National Institute for Radiological Sciences (NIRS) in Japan [Mori et al, 2016]. …”

Section: Study Limitationsmentioning

confidence: 99%

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In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

et al. 2016

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Stereotactic body image guided radiation therapy (SBRT) shows excellent results for the local control of early stage lung cancer. However, not all patients are eligible for SBRT, and advanced stage treatment is less successful and often associated with severe side effects. Scanned carbon ion therapy (PT) can deliver more conformal dose likely benefiting these patient groups.Therefore an in silico trial was conducted on early and advanced stage patients to identify potential advantages of PT. The patients were treated with SBRT at Champalimaud Center for the Unknown, Lisbon (Portugal). PT plans were simulated on 4DCTs, and rescanning was investigated for motion mitigation in 4D-dose calculations. A dedicated strategy for 4D intensity modulated particle therapy (IMPT) was developed and applied for advanced stage patients with multiple lesions. For clinically valid and reliable results the deformable image registrationnecessary for 4D-dose calculation -a quality assurance tool was developed and applied in the study.The results showed that target coverage was comparable in SBRT and PT, while PT delivered significantly lower doses to most critical structures, especially the heart, lungs, and esophagus.A highly complex case of advanced stage lung cancer could be treated in a single fraction of 24 Gy with PT, while SBRT could not deliver the full ablative dose treatment due to an excessive heart dose. The mean heart dose was reduced from 10 Gy to 0.8 Gy with PT for this specific patient.

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Section: Summary and Discussionmentioning

confidence: 99%

Section: Motivationmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

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In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

et al. 2016

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“…The proton radiotherapy group in Sapporo will soon start online x-ray image guided scanned proton treatment . Researchers at Heidelberg Ion-Beam therapy centre (HIT) have treated liver patients with scanned carbon beams [Habermehl 2013] and the group at National Institute of Radiological Sciences (NIRS) started gated scanned treatment for lung and liver , Mori 2016. These are only a few examples for the rapid clinical development towards scanned particle treatments for moving targets.…”

Section: Treatment Of Moving Targets With Proton Beamsmentioning

confidence: 99%

Required transition from research to clinical application: Report on the 4D treatment planning workshops 2014 and 2015

et al. 2016

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Since 2009, a 4D treatment planning workshop has taken place annually, gathering researchers working on the treatment of moving targets, mainly with scanned ion beams. Topics discussed during the workshops range from problems of time resolved imaging, the challenges of motion modelling, the implementation of 4D capabilities for treatment planning, up to different aspects related to 4D dosimetry and treatment verification. This report gives an overview on topics discussed at the 4D workshops in 2014 and 2015. It summarizes recent findings, developments and challenges in the field and discusses the relevant literature of the recent years. The report is structured in three parts pointing out developments in the context of understanding moving geometries, of treating moving targets and of 4D quality assurance (QA) and 4D dosimetry. The community represented at the 4D workshops agrees that research in the context of treating moving targets with scanned ion beams faces a crucial phase of clinical translation. In the coming years it will be important to define standards for motion monitoring, to establish 4D treatment planning guidelines and to develop 4D QA tools. These basic requirements for the clinical application of scanned ion beams to moving targets could e.g. be determined by a dedicated ESTRO task group. Besides reviewing recent research results and pointing out urgent needs when treating moving targets with scanned ion beams, the report also gives an outlook on the upcoming 4D workshop organized at the University Medical Center Groningen (UMCG) in the Netherlands at the end of 2016.

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“…We have already described respiratory-gated markerless tumour tracking for lung and liver tumours. 25 However, precise treatment for the pancreas probably requires fiducial markers for fluoroscopy. The feasibility of implanting fiducial markers in the pancreas and using the internal gating system before implementing dose increases requires confirmation.…”

Section: Discussionmentioning

confidence: 99%

Dose escalation study with respiratory-gated carbon-ion scanning radiotherapy using a simultaneous integrated boost for pancreatic cancer: simulation with four-dimensional computed tomography

Kawashiro

Mori

Yamada

et al. 2017

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We quantified dose escalation with respiratory-gated C-PBS using SIB for pancreatic cancer and revealed that OAR dose was not affected to the same degree as the tumour dose. Advances in knowledge: A simulation study on respiratory-gated C-PBS with SIB for pancreatic cancer was performed. The results indicated the feasibility of dose escalation for pancreatic cancer, which should be confirmed in clinical trials.

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Carbon Ion Pencil Beam Scanning Treatment With Gated Markerless Tumor Tracking: An Analysis of Positional Accuracy

Cited by 20 publications

References 0 publications

In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

Required transition from research to clinical application: Report on the 4D treatment planning workshops 2014 and 2015

Dose escalation study with respiratory-gated carbon-ion scanning radiotherapy using a simultaneous integrated boost for pancreatic cancer: simulation with four-dimensional computed tomography

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