Hubert Y Pan1, Shengpeng Jiang2, Jordan Sutton1, Zhongxing Liao1, William W Chance1, Steven J Frank1, X Ronald Zhu3, Heng Li3, Hiral P Fontanilla1, Xiaodong Zhang3, Daniel R Gomez4. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China. 3. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 4. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: DGomez@mdanderson.org.
Abstract
PURPOSE: The purpose of this study was to describe our experience implementing intensity modulated proton therapy (IMPT) for lung-intact malignant pleural mesothelioma (MPM), including patient selection, treatment planning, dose verification, and process optimization. METHODS AND MATERIALS: Seven patients with epithelioid MPM were reviewed; 6 underwent pleurectomy, whereas 1 had biopsy alone. Four patients received IMPT and 3 received intensity modulated radiation therapy. Treatment plans for the other modality were created for dosimetric comparisons. Quality assurance processes included dose verification and robustness analysis. Image-guided setup was performed with the first isocenter, and couch shifts were applied to reposition to the second isocenter. RESULTS: Treatment with IMPT was well tolerated and completed without breaks. IMPT plans were designed with 2 isocenters, 4 beams, and ≤64 energy layers per beam. Dose verification processes were completed in 3 hours. Total daily treatment time was approximately 45 minutes (20 minutes for setup and 25 minutes for delivery). IMPT produced lower mean doses to the contralateral lung, heart, esophagus, liver, and ipsilateral kidney, with increased contralateral lung sparing when mediastinal boost was required for nodal disease. CONCLUSIONS: Our initial experience showed that IMPT was feasible for routine care of patients with lung-intact MPM.
PURPOSE: The purpose of this study was to describe our experience implementing intensity modulated proton therapy (IMPT) for lung-intact malignant pleural mesothelioma (MPM), including patient selection, treatment planning, dose verification, and process optimization. METHODS AND MATERIALS: Seven patients with epithelioid MPM were reviewed; 6 underwent pleurectomy, whereas 1 had biopsy alone. Four patients received IMPT and 3 received intensity modulated radiation therapy. Treatment plans for the other modality were created for dosimetric comparisons. Quality assurance processes included dose verification and robustness analysis. Image-guided setup was performed with the first isocenter, and couch shifts were applied to reposition to the second isocenter. RESULTS: Treatment with IMPT was well tolerated and completed without breaks. IMPT plans were designed with 2 isocenters, 4 beams, and ≤64 energy layers per beam. Dose verification processes were completed in 3 hours. Total daily treatment time was approximately 45 minutes (20 minutes for setup and 25 minutes for delivery). IMPT produced lower mean doses to the contralateral lung, heart, esophagus, liver, and ipsilateral kidney, with increased contralateral lung sparing when mediastinal boost was required for nodal disease. CONCLUSIONS: Our initial experience showed that IMPT was feasible for routine care of patients with lung-intact MPM.
Authors: Li Liao; Gino J Lim; Yupeng Li; Juan Yu; Narayan Sahoo; Heng Li; Michael Gillin; X Ronald Zhu; Anita Mahajan; Steven J Frank; David R Grosshans; Quynh-Nhu Nguyen; Daniel Gomez; Xiaodong Zhang Journal: Int J Part Ther Date: 2016-12-30
Authors: Ellen D Yorke; Andrew Jackson; Li Cheng Kuo; Anthonia Ojo; Kelly Panchoo; Prasad Adusumilli; Marjorie G Zauderer; Valerie W Rusch; Annemarie Shepherd; Andreas Rimner Journal: Int J Radiat Oncol Biol Phys Date: 2017-04-27 Impact factor: 7.038