ArticleRadiation oncology (London, England)2018
Significance of intra-fractional motion for pancreatic patients treated with charged particles.
Article in Radiation oncology (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Prospective Phase 2 Clinical Trial of Carbon Ion Radiation Therapy Combined With Chemotherapy for Locally Advanced Pancreatic Carcinoma.International journal of radiation oncology, biology, physics · 2025Trial
- An ESTRO-EPTN Delphi consensus on robustness evaluation in proton therapy.Physics and imaging in radiation oncology · 2026Article
- Effect of breathing phase number on the 4D robust optimization for pancreatic cancer intensity modulated proton therapy.BMC cancer · 2024Article
- Patient Breathing Motion and Delivery Specifics Influencing the Robustness of a Proton Pancreas Irradiation.Cancers · 2023Article
- Article
- Deep learning-based prediction of deliverable adaptive plans for MR-guided adaptive radiotherapy: A feasibility study.Frontiers in oncology · 2023Article
- Investigating the use of virtual 4DCT from 4DMRI in gated carbon ion radiation therapy of abdominal tumors.Zeitschrift fur medizinische Physik · 2022Article
- Dosimetric impact of simulated changes in large bowel content during proton therapy with simultaneous integrated boost for locally advanced pancreatic cancer.Journal of applied clinical medical physics · 2021Article
- The first real-time intrafraction target position monitoring in pancreas SBRT on an Elekta linear accelerator.Physical and engineering sciences in medicine · 2021Article
- Respiratory Motion Mitigation and Repeatability of Two Diffusion-Weighted MRI Methods Applied to a Murine Model of Spontaneous Pancreatic Cancer.Tomography (Ann Arbor, Mich.) · 2021Article
- Impact of interfractional anatomical variation and setup correction methods on interfractional dose variation in IMPT and VMAT plans for pancreatic cancer patients: A planning study.Journal of applied clinical medical physics · 2020Article
- Comparison of pancreatic respiratory motion management with three abdominal corsets for particle radiation therapy: Case study.Journal of applied clinical medical physics · 2019Article
- Effect of setup and inter-fraction anatomical changes on the accumulated dose in CT-guided breath-hold intensity modulated proton therapy of liver malignancies.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2019Article
- 4DMRI-based investigation on the interplay effect for pencil beam scanning proton therapy of pancreatic cancer patients.Radiation oncology (London, England) · 2019Article
- Comparison of different treatment planning approaches for intensity-modulated proton therapy with simultaneous integrated boost for pancreatic cancer.Radiation oncology (London, England) · 2018Article
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6 authors.
Funding
Abstract
backgroundUncertainties associated with the delivery of treatment to moving organs might compromise the accuracy of treatment. This study explores the impact of intra-fractional anatomical changes in pancreatic patients treated with charged particles delivered using a scanning beam. The aim of this paper is to define the potential source of uncertainties, quantify their effect, and to define clinically feasible strategies to reduce them.
methodsThe study included 14 patients treated at our facility with charged particles (protons or 12C) using intensity modulated particle therapy (IMPT). Treatment plans were optimized using the Treatment Planning System (TPS) Syngo® RT Planning. The pre-treatment dose distribution under motion (4D) was simulated using the TPS TRiP4D and the dose delivered for some of the treatment fractions was reconstructed. The volume receiving at least 95% of the prescribed dose (V95CTV) and the target dose homogeneity were evaluated. The results from the 4D dose calculations were compared with dose distributions in the static case and its variation correlated with the internal motion amplitude and plan modulation, through the Pearson correlation coefficient, as well the significant p-value. The concept of the modulation index (MI) was introduced to assess the degree of modulation of IMPT plans, through the quantification of intensity gradients between neighboring pencil beams.
resultsThe induced breathing motion together with dynamic beam delivery results in an interplay effect, which affects the homogeneity and target coverage of the dose distribution. This effect is stronger (∆V
conclusionsUnder internal motion the use of inhomogeneous plans results in a decrease in the dose homogeneity and target coverage of dose distributions in comparison to the static case. Plan robustness can be improved by using multiple beams and avoiding beam entrance directions susceptible to density changes. 4D dose calculations support the selection of the most suitable plan for the specific patient's anatomy.
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