ArticleBMC cancer2025
Quantifying interplay effects in lung cancer IMPT: a comprehensive analysis of treatment planning parameter sensitivity.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- An ESTRO-EPTN Delphi consensus on robustness evaluation in proton therapy.Physics and imaging in radiation oncology · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
purposePrecise dose delivery to the target is constrained by respiratory motion in intensity modulated proton therapy (IMPT) for lung cancer. This study aims to investigate the impact of treatment planning parameters on the lung cancer IMPT. MATERIALS AND
methods30 lung cancer patients treated at Shandong Cancer Hospital and institute were recruited in the study. A 4DCT dataset with 10 respiratory phases was reconstructed for each patient. The RayStation11B treatment planning system was used to create two-oblique-field IMPT plans. A prescription dose of 60 Gy (RBE) for 30 fractions was administered to 95% volume of the CTV. Five proton planning strategies were developed for each patient: (1) Range shifter (RS) plan: four plans were generated by varying range shifter thickness (0, 2, 3, and 5 cm) to change spot sizes; (2) Layer Spacing (LS) plan: four plans with different layer spacing (0.5, 1, 1.5 and 2 cm); (3) Spot Spacing (SS) plan: four plans with spot spacing variations (0.5, 1, 1.5 and 2 cm); (4) Repainting (RE) plan: layer repainting techniques with different numbers of repainting 1, 4 or 8 was adopted to the plan; (5) Ring plan: Dose fall-off was optimized using a ring structure around the target. 4D dynamic dose distributions (4DDDs) were calculated for plans created with various treatment planning parameters. Plan quality and dose-volume histogram (DVH) parameters for the target and organs at risk (OARs) were then analyzed.
resultsFor the RS plan, the D
conclusionA systematic analysis was conducted in this study on the impact of spot size, LS, SS, layer repainting, and ring structure on the 4D robustness of IMPT plans for lung cancer patients. These five strategies demonstrated that beam spot size and layer spacing affected plan robustness, while spot spacing had relatively minor influence on robustness. The repainting technology can mitigate the interplay effect caused by respiratory motion. The application of ring structures affected the dose distribution of the moving target.
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