ArticleRadiation oncology (London, England)2024
Impact of interplay effects on spot scanning proton therapy with motion mitigation techniques for lung cancer: SFUD versus robustly optimized IMPT plans utilizing a four-dimensional dynamic dose simulation tool.
Article in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Dosimetric comparison of scanned proton therapy and volumetric modulated arc therapy in isodose-prescribed stereotactic body radiotherapy for lung cancer.Journal of radiation research · 2026Article
- Proton stereotactic body radiotherapy for early-stage non-small cell lung cancer: Influence of case-specific characteristics on dosimetric robustness.Journal of applied clinical medical physics · 2026Article
- Beam commissioning of a new compact scanned proton therapy system with four different dose calculation algorithms.Journal of applied clinical medical physics · 2026Article
- Comparative evaluation of static and dynamic 4D dose recalculations in pencil beam scanning proton therapy for oesophageal cancer.Physics and imaging in radiation oncology · 2026Article
- Influence of Residual Motion Within the Gating Window on Dose Distribution in Respiratory-gated Proton Therapy.In vivo (Athens, Greece)Article
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Authors and funding
14 authors.
Funding
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Abstract
backgroundThe interaction between breathing motion and scanning beams causes interplay effects in spot-scanning proton therapy for lung cancer, resulting in compromised treatment quality. This study investigated the effects and clinical robustness of two types of spot-scanning proton therapy with motion-mitigation techniques for locally advanced non-small cell lung cancer (NSCLC) using a new simulation tool (4DCT-based dose reconstruction).
methodsThree-field single-field uniform dose (SFUD) and robustly optimized intensity-modulated proton therapy (IMPT) plans combined with gating and re-scanning techniques were created using a VQA treatment planning system for 15 patients with locally advanced NSCLC (70 GyRBE/35 fractions). In addition, gating windows of three or five phases around the end-of-expiration phase and two internal gross tumor volumes (iGTVs) were created, and a re-scanning number of four was used. First, the static dose (SD) was calculated using the end-of-expiration computed tomography (CT) images. The four-dimensional dynamic dose (4DDD) was then calculated using the SD plans, 4D-CT images, and the deformable image registration technique on end-of-expiration CT. The target coverage (V
resultsIn the 3- and 5-phase SFUD, statistically significant differences between the SD and 4DDD groups were observed for V
conclusionsInterplay effects minimally impacted target coverage and OAR doses in SFUD and robustly optimized IMPT with 3-phase gating and re-scanning for locally advanced NSCLC. However, target coverage significantly declined with an increased gating window. Robustly optimized IMPT showed superior resilience to interplay effects, ensuring better target coverage, prescription dose adherence, and homogeneity than SFUD.
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