Gated carbon-ion scanning treatment for pancreatic tumour with field specific target volume and organs at risk

Miki, K.; Mori, Shinichiro; Shiomi, Miho; Yamada, Shigeru

doi:10.1016/j.ejmp.2016.11.009

Cited by 14 publications

(6 citation statements)

References 20 publications

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“…Hence, the use of asymmetric field specific margins was evaluated, which was already investigated by Park et al [21] as an approach to mitigate range uncertainties. Also, Miki et al [22] investigated the use of field-specific target and OARS but for the case of intra-fractional changes. In our study, the obtained ITV WEPL , based on Graeff et al [11] study, preserves the CTV coverage over the set of weekly-CTs, including the inter-fractional anatomical changes.…”

Section: Discussionmentioning

confidence: 99%

Planning strategies for inter-fractional robustness in pancreatic patients treated with scanned carbon therapy

et al. 2017

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BackgroundManaging inter-fractional anatomy changes is a challenging task in radiotherapy of pancreatic tumors, especially in scanned carbon-ion delivery. This treatment planning study aims to focus on clinically feasible solutions, such as the beam angle selection and margin design to increase the robustness against inter-fractional uncertainties.MethodsThis study included 10 patients with weekly 3D-CT imaging and physician-approved Clinical Target Volume (CTV). The study was directed to keep the CTV-coverage using six beam angle configurations in combination with different Internal Target Volume (ITV) concepts. These were: geometric-margin (symmetric 3 and 5 mm margin); range-equivalent margins with an isotropic HU replacement; and to evaluate the need of asymmetric margins the water-equivalent range path (WEPL) was determined per patient from the set of CTs.Plan optimization and forward dose calculation in each week-CT were performed with the research treatment planning system TRiP98 and the plan quality evaluated in terms of CTV coverage (V95CTV) and homogeneity dose (HCTV = D5-D95).ResultsThe beam geometry had a substantial impact on the target irradiation over the treatment course, with the single posterior or two beams showing the best average coverage of the CTV. The use of geometric margins for the more robust beam geometries showed acceptable results, with a V95CTV of (99.2 ± 1.2)% for the 5 mm-margin. For the non-robust configurations, due to substantial changes in the radiological depth, the use of this margin results in a V95CTV that might be below 80%, only showing improvement when the range changes are included.ConclusionsSelection of adequate beam configurations and treatment margins in ion-beam therapy of pancreatic tumors is of great importance. For a single posterior beam or two beam configurations, application of geometrical margins compensate for dose degradation induced by inter-fractional anatomy changes for the majority of the analyzed treatment fractions.Electronic supplementary materialThe online version of this article (doi:10.1186/s13014-017-0832-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Planning strategies for inter-fractional robustness in pancreatic patients treated with scanned carbon therapy

et al. 2017

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“…But breathing and heart beat leads to organ motion that may interfere with the scanning procedure and yield inhomogeneous dose distributions as well as spreading of a significant dose outside the planned target volume. For the compensation of target motion, different strategies have been proposed such as multiple repainting, which reduces dose inhomogeneities but increases the target volume, gating, where the tumour is irradiated only in a predefined position or fast 3D beam tracking [93] , [94] , [95] , which would restore the congruence of irradiated and planned target volume but which has not been realized at HIT up to now. Clinically, however, only the gating techniques has been used so far.…”

Section: The Heidelberg Ion-beam Therapy Centermentioning

confidence: 99%

The history of ion beam therapy in Germany

Jäkel

Kraft

Karger

2022

Zeitschrift für Medizinische Physik

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“…However, this appears insufficient. The intra-fraction changes in gastrointestinal gas volume also affected the target dose distribution in patients with pancreatic cancer [27]. Therefore, particular attention must be paid to the effects of intra-fractional anatomical changes on dose distribution, which are further discussed below.…”

Section: Precise Radiation Deliverymentioning

confidence: 99%

“…In addition, considering the intra-fractional beam range variations, the internal target volume may not be useful for C-ion RT. Thus, the field-specific target volume (FTV) was introduced to compensate for intra-fractional range variation, and attained improved dose coverage of the target region for patients with lung, liver, and pancreatic cancer [27,30]. Using FTV clinically requires a high reproduction of intra-fractional motions.…”

Section: Planning Target Volume Margin Reductionmentioning

confidence: 99%

Value of Three-Dimensional Imaging Systems for Image-Guided Carbon Ion Radiotherapy

Kubota

Tashiro

et al. 2019

Cancers

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Carbon ion radiotherapy (C-ion RT) allows excellent dose distribution because of the Bragg Peak. Compared with conventional radiotherapy, it delivers a higher dose with a smaller field. However, the dose distribution is sensitive to anatomical changes. Imaging technologies are necessary to reduce uncertainties during treatment, especially for hypofractionated and adaptive radiotherapy (ART). In-room computed tomography (CT) techniques, such as cone-beam CT (CBCT) and CT-on-rails are routinely used in photon centers and play a key role in improving treatment accuracy. For C-ion RT, there is an increasing demand for a three-dimensional (3D) image-guided system because of the limitations of the present two-dimensional (2D) imaging verification technology. This review discusses the current imaging system used in carbon ion centers and the potential benefits of a volumetric image-guided system.

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Gated carbon-ion scanning treatment for pancreatic tumour with field specific target volume and organs at risk

Cited by 14 publications

References 20 publications

Planning strategies for inter-fractional robustness in pancreatic patients treated with scanned carbon therapy

Planning strategies for inter-fractional robustness in pancreatic patients treated with scanned carbon therapy

The history of ion beam therapy in Germany

Value of Three-Dimensional Imaging Systems for Image-Guided Carbon Ion Radiotherapy

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