Uncertainty incorporated beam angle optimization for IMPT treatment planning

Cao, Wenhua; Lim, Gino J.; Lee, Andrew; Li, Yupeng; Liu, Wei; Zhu, Xiaorong Ronald; Zhang, Xiaodong

doi:10.1118/1.4737870

Cited by 52 publications

(59 citation statements)

References 55 publications

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“…Such dose distributions are highly sensitive to the uncertainties mentioned above and carry a risk of both underdosing or overdosing target volumes and/or normal structures. To minimize many of these uncertainties and their effect, advanced immobilization techniques, image guidance, optimal beam angle selection, robust analysis, robust optimization, and adaptive planning are all being actively investigated (27-29). With MFO-IMPT, image guidance should be performed daily with either daily KV imaging and periodic CT verification scans or in-room CT-based volumetric imaging.…”

Section: Discussionmentioning

confidence: 99%

Multifield Optimization Intensity Modulated Proton Therapy for Head and Neck Tumors: A Translation to Practice

Frank

Cox

Gillin

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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132

120

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Summary The first fifteen consecutive patients treated with multi-field optimization intensity modulated proton therapy (MFO-IMPT) were able to complete treatment with no need for treatment breaks and no hospitalizations. Ten patients presented with SCC and 5 with ACC. There were no treatment-related deaths and with a median follow-up of 28 months, the overall clinical complete response rate was 93.3%. Early clinical outcomes warrant further investigation of proton therapy in the management of head and neck malignancies. Background We report the first clinical experience and toxicity of multi-field optimization (MFO) intensity-modulated proton therapy (IMPT) for patients with head and neck tumors. Methods Fifteen consecutive patients with head and neck cancer underwent MFO-IMPT with active scanning beam proton therapy. Patients with SCC had comprehensive treatment extending from the base of the skull to the clavicle. The dose for chemoradiation therapy and radiation therapy alone was 70 Gy and 66 Gy, respectively. The robustness of each treatment plan was also analyzed to evaluate sensitivity to uncertainties associated with variations in patient setup and the effect of uncertainties with proton beam range in patients. Proton beam energies during treatment ranged from 72.5 to 221.8 MeV. Spot sizes varied depending on the beam energy and depth of the target, and the scanning nozzle delivered the spot scanning treatment “spot-by-spot” and “layer-by-layer” Results Ten patients presented with squamous cell carcinoma (SCC) and 5 with adenoid cystic carcinoma (ACC). All 15 patients were able to complete treatment with MFO-IMPT with no need for treatment breaks and no hospitalizations. There were no treatment-related deaths and with a median follow-up of 28 months (range: 20-35), the overall clinical complete response rate was 93.3% (95%, confidence interval 68.1% to 99.8%). Xerostomia occurred in all 15 patients as follows; Grade 1 - ten patients, Grade 2 - four patients, and Grade 3 - one patient. Mucositis within the planning target volumes was seen during the treatment of all patients; Grade 1 - one patient, Grade 2 - eight patients, and Grade 3 - six patients. No patient experienced Grade 2 or higher anterior oral mucositis. Conclusions This is the first clinical report of MFO-IMPT for head and neck tumors. Early clinical outcomes are encouraging and warrant further investigation of proton therapy in prospective clinical trials.

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Section: Discussionmentioning

confidence: 99%

Multifield Optimization Intensity Modulated Proton Therapy for Head and Neck Tumors: A Translation to Practice

Frank

Cox

Gillin

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

Self Cite

132

120

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“…Therefore, these results reconfirm the importance of beam arrangement in IMPT planning. Further study should now be done to determine, although beam angle optimization [24] and robust optimization techniques [25] may solve a problem of the beam arrangement.…”

Section: Discussionmentioning

confidence: 99%

Dose Comparison between Eclipse Dose Calculation and Fast Dose Calculator in Single- and Multi-Field Optimization Intensity-Modulated Proton Therapy Plans with Various Multi-Beams for Brain Cancer

Kohno¹,

Cao²,

Bai³

et al. 2017

IJMPCERO

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The purpose of this study was to grasp current potential problems of dose error in intensity-modulated proton therapy (IMPT) plans. We were interested in dose differences of the Varian Eclipse treatment planning system (TPS) and the fast dose calculation method (FDC) for single-field optimization (SFO) and multi-field optimization (MFO) IMPT plans. In addition, because some authors have reported dosimetric benefit of a proton arc therapy with ultimate multi-fields in recent years, we wanted to evaluate how the number of fields and beam angles affect the differences for IMPT plans. Therefore, for one brain cancer patient with a large heterogeneity, SFO and MFO IMPT plans with various multi-angle beams were planned by the TPS. Dose distributions for each IMPT plan were calculated by both the TPS's conventional pencil beam algorithm and the FDC. The dosimetric parameters were compared between the two algorithms. The TPS overestimated 400 -500 cGy (RBE) for minimum dose to the CTV relative to the dose calculated by the FDC. These differences indicate clinically relevant effect on clinical results. In addition, we observed that the maximum difference in dose calculated between the TPS and the FDC was about 900 cGy (RBE) for the right optic nerve, and this quantity also has a possibility to have a clinical effect. The major difference was not seen in calculations for SFO IMPT planning and those for MFO IMPT planning. Differences between the TPS and the FDC in SFO and MFO IMPT plans depend strongly on beam arrangement and the presence of a heterogeneous body. We advocate use of a Monte Carlo method in proton treatment planning to deliver the most precise proton dose in IMPT.

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“…The penalty score formula, which is widely used in the literature [9,26,37], is consistent across the 10 patients. Scores are weighted sums of violations of the desired dose values for both the OARs and the PTVs.…”

Section: Penalty Score To Evaluate Plan Qualitymentioning

confidence: 99%

“…A set of angles is then constructed based on the performance of the individual beam plans. Methods of optimizing using the beam view method include simulated annealing [2], mixed integer programming [13,19,22,45], genetic algorithms [20,41], clustering [4] and heuristic approaches [2,5,9,11,14,21,26,31].…”

Section: Introductionmentioning

confidence: 99%

Data mining to aid beam angle selection for intensity-modulated radiation therapy

Price

Golden

Wasil

et al. 2014

Proceedings of the 5th ACM Conference on Bioinformatics, Computational Biology, and Health Informatics

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Research on the beam angle optimization problem for intensitymodulated radiation therapy (IMRT) has focused on developing optimization approaches to obtain a single highquality angle set for each patient. In this paper, we propose a population-based method to aid the beam angle selection process with the goal of significantly improving the efficiency of the process while identifying high-quality angle sets. We use a database of approximately 2,700 IMRT treatment plans for 10 patients with locally advanced head and neck cancer to train three data mining techniques (linear regression, neural networks, and k-nearest neighbor) to rank treatment plans based on potential quality. Using 5-fold cross-validation, we train our models to rank a list of 54 new beam angle plans (for a total of 50 lists) and then fully evaluate a set of the most promising plans. Our models can, choosing only three plans out of 54, correctly identify at least one of the top three plans up to 76% of the time. Furthermore, 34% of the time we find the top plan. By sorting the plans prior to full evaluation, we are able to find the better plans faster.

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Uncertainty incorporated beam angle optimization for IMPT treatment planning

Cited by 52 publications

References 55 publications

Multifield Optimization Intensity Modulated Proton Therapy for Head and Neck Tumors: A Translation to Practice

Multifield Optimization Intensity Modulated Proton Therapy for Head and Neck Tumors: A Translation to Practice

Dose Comparison between Eclipse Dose Calculation and Fast Dose Calculator in Single- and Multi-Field Optimization Intensity-Modulated Proton Therapy Plans with Various Multi-Beams for Brain Cancer

Data mining to aid beam angle selection for intensity-modulated radiation therapy

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