The Potential of Heavy-Ion Therapy to Improve Outcomes for Locally Advanced Non-Small Cell Lung Cancer

Chun, Stephen G.; Solberg, Timothy D.; Grosshans, David R.; Nguyen, Quynh Nhu; Simone, Charles B.; Mohan, Radhe; Liao, Zhongxing; Hahn, Stephen M.; Herman, Joseph M.; Frank, Steven J.

doi:10.3389/fonc.2017.00201

Cited by 7 publications

(9 citation statements)

References 26 publications

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“…Lung cancer is one of the leading causes of cancer‐related deaths in both men and women worldwide with respiration‐related motion providing the biggest challenge to an efficient treatment . Radiation dose to the heart is one of the main factors affecting survival and patient‐reported quality of life . Motion‐induced anatomical changes may result in significant errors in imaging, treatment planning, which, in turn, affect radiation delivery .…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Because of characteristics such as the Bragg peak, lower oxygen enhancement ratio (OER), and higher relative biological effectiveness, heavy ions could provide patient-specific treatment options for lung cancer. 1,3 Excellent dose localization for deep-seated tumors with critical organ dose sparing can be achieved by treating with heavy ions. 4,5 The additional benefit that carbon ions have, over other charged particles like protons, is an increased biological effectiveness because of dense ionization and the resulting complex DNA damage.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 Radiation dose to the heart is one of the main factors affecting survival and patient-reported quality of life. 1 Motion-induced anatomical changes may result in significant errors in imaging, treatment planning, which, in turn, affect radiation delivery. 15 Managing respiratory motion and adapting to subsequent changes in anatomy can make radiotherapy more precise especially for novel treatment methods like particle therapy, which are very sensitive to tumor motion.…”

Section: Introductionmentioning

confidence: 99%

“…Radiation therapy delivered with heavy ions, such as carbon ions, has unique biological and physical advantages that may improve local control, while reducing radiation exposure to nontarget organs at risk such as the heart . Because of characteristics such as the Bragg peak, lower oxygen enhancement ratio (OER), and higher relative biological effectiveness, heavy ions could provide patient‐specific treatment options for lung cancer . Excellent dose localization for deep‐seated tumors with critical organ dose sparing can be achieved by treating with heavy ions .…”

Section: Introductionmentioning

confidence: 99%

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Dosimetric evaluation of 4D‐CBCT reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for carbon ion therapy of lung cancer

et al. 2019

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Purpose Motion management is critical for the efficacy of carbon ion therapy for moving targets such as lung tumors. We evaluated the feasibility of using four‐dimensional cone beam computed tomography (4D‐CBCT) reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for dose calculation and accumulation in carbon ion treatment of lung cancer. Methods Motion‐compensated 4D‐CBCT images were reconstructed with the SMEIR algorithm to capture the most updated anatomy and motion with an updated interphase motion model on the treatment day. Projections of all CBCT phases were simulated from the planning 4D‐CT by the ray tracing technique. Treatment planning and dose calculation were performed with a GPU‐based Monte Carlo dose calculation software for carbon ion therapy. The treatment plan was optimized on the average computed tomography (CT) to obtain optimal intensity of the carbon ions. From the optimized plan, dose distributions on individual phases of 4D‐CT and 4D‐CBCT were calculated by the Monte Carlo‐based dose engine. Dose accumulation was performed on 4D‐CBCT images using deformable vector fields (DVF) generated by SMEIR. The accumulated planning target volume (PTV) dose based on 4D‐CBCT was then compared to the accumulated dose calculated on 4D‐CT, where the DVFs between different phases were obtained by the demons deformable registration algorithm. Results Dose value histograms (DVH) as well as absolute deviations of the maximum dose (ΔDmax), mean dose (ΔDmean), and dose coverage metrics (ΔV95% and ΔV100%) for PTV were quantitatively evaluated for the two sets of plans. Good agreement was found between the 4D‐CT and 4D‐CBCT‐based PTV‐DVH curves. The average values of ΔDmax, ΔDmean,ΔV95%, and ΔV100% calculated between the 4D‐CT and SMEIR‐4D‐CBCT‐based plans were 1.91%, 3.55%, 2.12%, and 1.15%, respectively, for the PTVs of ten patient case studies. Conclusions Based on these results, SMEIR‐reconstructed 4D‐CBCTs can potentially be used for motion estimation, dose evaluation, and adaptive treatment planning in lung cancer carbon ion therapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dosimetric evaluation of 4D‐CBCT reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for carbon ion therapy of lung cancer

et al. 2019

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“…These errors can lead to issues such as tumours not receiving the expected dose, or the heart (or other sensitive organs) receiving excessive radiation dose, having severe effects on both patient survival and complications [10]. To monitor and manage these issues, methods for monitoring and managing ventilation motion are being developed to create a treatment plan robustly optimized with respect to motion [11].…”

Section: Introductionmentioning

confidence: 99%

Anthropomorphic lung phantom based validation of in-room proton therapy 4D-CBCT image correction for dose calculation

Bondesson

Meijers

Janssens

et al. 2022

Zeitschrift für Medizinische Physik

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Ventilation-induced tumour motion remains a challenge for the accuracy of proton therapy treatments in lung patients. We investigated the feasibility of using a 4D virtual CT (4D-vCT) approach based on deformable image registration (DIR) and motion-aware 4D CBCT reconstruction (MA-ROOSTER) to enable accurate daily proton dose calculation using a gantry-mounted CBCT scanner tailored to proton therapy. Methods: Ventilation correlated data of 10 breathing phases were acquired from a porcine exvivo functional lung phantom using CT and CBCT. 4D-vCTs were generated by (1) DIR of the mid-position 4D-CT to the mid-position 4D-CBCT (reconstructed with the MA-ROOSTER) using a diffeomorphic Morphons algorithm and (2) subsequent propagation of the obtained mid-position vCT to the individual 4D-CBCT phases. Proton therapy treatment planning was performed to evaluate dose calculation accuracy of the 4D-vCTs. A robust treatment plan delivering a nominal dose of 60 Gy was generated on the average intensity image of the 4D-CT for an approximated internal target volume (ITV). Dose distributions were then recalculated on individual phases of the 4D-CT and the 4D-vCT based on the optimized plan. Dose accumulation was performed for 4D-vCT and 4D-CT using DIR of each phase to the mid position, which was chosen as reference. Dose based on the 4D-vCT was then evaluated against the dose calculated on 4D-CT both, phase-by-phase as well as accumulated, by comparing dose volume histogram (DVH) values (Dmean, D2%, D98%, D95%) for the ITV, and by a 3D-gamma index analysis (global, 3% / 3mm, 5 Gy, 20 Gy and 30 Gy dose thresholds). Results: Good agreement was found between the 4D-CT and 4D-vCT-based ITV-DVH curves. The relative differences ((CT-vCT)/CT) between accumulated values of ITV Dmean, D2%, D95% and D98% for the 4D-CT and 4D-vCT-based dose distributions were-0.2%, 0.0%,-0.1% and-0.1%, respectively. Phase specific values varied between-0.5%-0.2%,-0.2%-0.5%,-3.5%-1.5% and-5.7%-2.3%. The relative difference of accumulated Dmean over the lungs was 2.3% and Dmean for the phases varied between-5.4% and 5.8%. The gamma pass-rates with 5 Gy, 20 Gy and 30 Gy thresholds for the accumulated doses were 96.7.%, 99.6% and 99.9%, respectively. Phase-by-phase comparison yielded pass-rates between 86%-97%, 88%-98% and 94%-100%. 2 Conclusions: Feasibility of the suggested 4D-vCT workflow using proton therapy specific imaging equipment was shown. Results indicate the potential of the method to be applied for daily 4D proton dose estimation.

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Effects of crystallographic and geometric orientation on ion beam sputtering of gold nanorods

Hinks¹,

Hibberd²,

Hattar³

et al. 2018

Sci Rep

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Nanostructures may be exposed to irradiation during their manufacture, their engineering and whilst in-service. The consequences of such bombardment can be vastly different from those seen in the bulk. In this paper, we combine transmission electron microscopy with in situ ion irradiation with complementary computer modelling techniques to explore the physics governing the effects of 1.7 MeV Au ions on gold nanorods. Phenomena surrounding the sputtering and associated morphological changes caused by the ion irradiation have been explored. In both the experiments and the simulations, large variations in the sputter yields from individual nanorods were observed. These sputter yields have been shown to correlate with the strength of channelling directions close to the direction in which the ion beam was incident. Craters decorated by ejecta blankets were found to form due to cluster emission thus explaining the high sputter yields.

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The Potential of Heavy-Ion Therapy to Improve Outcomes for Locally Advanced Non-Small Cell Lung Cancer

Cited by 7 publications

References 26 publications

Dosimetric evaluation of 4D‐CBCT reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for carbon ion therapy of lung cancer

Dosimetric evaluation of 4D‐CBCT reconstructed by Simultaneous Motion Estimation and Image Reconstruction (SMEIR) for carbon ion therapy of lung cancer

Anthropomorphic lung phantom based validation of in-room proton therapy 4D-CBCT image correction for dose calculation

Effects of crystallographic and geometric orientation on ion beam sputtering of gold nanorods

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