Filippo Ammazzalorso1, Sebastian Graef2, Uli Weber2, Andrea Wittig2, Rita Engenhart-Cabillic2, Urszula Jelen2. 1. Department of Radiotherapy and Radiation Oncology, University of Marburg, Germany; Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany. Electronic address: filippo.ammazzalorso@uni-marburg.de. 2. Department of Radiotherapy and Radiation Oncology, University of Marburg, Germany.
Abstract
BACKGROUND AND PURPOSE: Scanned-beam interplay with the intrafraction target motion may result in dose deterioration in particle therapy. The magnitude of this effect and the possibilities to mitigate it were investigated for carbon ion prostate treatments. METHODS AND MATERIALS: For 12 prostate cases, 9 carbon ion treatment plans were prepared using 3 scanned-beam settings (spot sizes of 6, 7 and 9 mm and, respectively, raster pitches of 2, 2 and 3 mm) for 3 planning margins (3, 6 and 9 mm). Plans were recomputed in presence of 5 intrafraction prostate motion scenarios with and without intra-beam motion compensation. RESULTS: For 6 mm margin and 7 mm spot, the median (max) CTV D(95%) change was -0.2 (-2.6) pp (percentual points) with pure drift motion, -3.8 (-6.0) pp and -2.8 (-3.1) pp in transient motion scenarios and -4.8 (-7.7) pp and -1.8 (-5.7) pp in mixed motion scenarios. No particular raster setting brought distinct advantage, while planning margin expansion showed statistically significant effects for drift-dominated scenarios. Intra-beam motion compensation yielded improved CTV coverage. CONCLUSION: Intrafraction prostate motion can lead to marked target coverage deterioration, dependent on individual motion patterns, which can be only partially avoided through planning-time countermeasures. Among possible delivery-time countermeasures, intra-beam motion compensation is capable of improving target coverage.
BACKGROUND AND PURPOSE: Scanned-beam interplay with the intrafraction target motion may result in dose deterioration in particle therapy. The magnitude of this effect and the possibilities to mitigate it were investigated for carbon ion prostate treatments. METHODS AND MATERIALS: For 12 prostate cases, 9 carbon ion treatment plans were prepared using 3 scanned-beam settings (spot sizes of 6, 7 and 9 mm and, respectively, raster pitches of 2, 2 and 3 mm) for 3 planning margins (3, 6 and 9 mm). Plans were recomputed in presence of 5 intrafraction prostate motion scenarios with and without intra-beam motion compensation. RESULTS: For 6 mm margin and 7 mm spot, the median (max) CTV D(95%) change was -0.2 (-2.6) pp (percentual points) with pure drift motion, -3.8 (-6.0) pp and -2.8 (-3.1) pp in transient motion scenarios and -4.8 (-7.7) pp and -1.8 (-5.7) pp in mixed motion scenarios. No particular raster setting brought distinct advantage, while planning margin expansion showed statistically significant effects for drift-dominated scenarios. Intra-beam motion compensation yielded improved CTV coverage. CONCLUSION: Intrafraction prostate motion can lead to marked target coverage deterioration, dependent on individual motion patterns, which can be only partially avoided through planning-time countermeasures. Among possible delivery-time countermeasures, intra-beam motion compensation is capable of improving target coverage.