Marcus Fager1, Iuliana Toma-Dasu2, Maura Kirk3, Derek Dolney3, Eric S Diffenderfer3, Neha Vapiwala3, Alejandro Carabe4. 1. Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Medical Radiation Physics, Stockholm University, Stockholm, Sweden. Electronic address: Marcus.Fager@UPHS.UPenn.edu. 2. Medical Radiation Physics, Stockholm University and Karolinska Institutet, Stockholm, Sweden. 3. Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 4. Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: Alejandro.Carabe-Fernandez@UPHS.UPenn.edu.
Abstract
PURPOSE: The purpose of this study was to propose a proton treatment planning method that trades physical dose (D) for dose-averaged linear energy transfer (LETd) while keeping the radiobiologically weighted dose (DRBE) to the target the same. METHODS AND MATERIALS: The target is painted with LETd by using 2, 4, and 7 fields aimed at the proximal segment of the target (split target planning [STP]). As the LETd within the target increases with increasing number of fields, D decreases to maintain the DRBE the same as the conventional treatment planning method by using beams treating the full target (full target planning [FTP]). RESULTS: The LETd increased 61% for 2-field STP (2STP) compared to FTP, 72% for 4STP, and 82% for 7STP inside the target. This increase in LETd led to a decrease of D with 5.3 ± 0.6 Gy for 2STP, 4.4 ± 0.7 Gy for 4STP, and 5.3 ± 1.1 Gy for 7STP, keeping the Drbe at 90% of the volume (Drbe, 90) constant to FTP. CONCLUSIONS: LETd painting offers a method to reduce prescribed dose at no cost to the biological effectiveness of the treatment.
PURPOSE: The purpose of this study was to propose a proton treatment planning method that trades physical dose (D) for dose-averaged linear energy transfer (LETd) while keeping the radiobiologically weighted dose (DRBE) to the target the same. METHODS AND MATERIALS: The target is painted with LETd by using 2, 4, and 7 fields aimed at the proximal segment of the target (split target planning [STP]). As the LETd within the target increases with increasing number of fields, D decreases to maintain the DRBE the same as the conventional treatment planning method by using beams treating the full target (full target planning [FTP]). RESULTS: The LETd increased 61% for 2-field STP (2STP) compared to FTP, 72% for 4STP, and 82% for 7STP inside the target. This increase in LETd led to a decrease of D with 5.3 ± 0.6 Gy for 2STP, 4.4 ± 0.7 Gy for 4STP, and 5.3 ± 1.1 Gy for 7STP, keeping the Drbe at 90% of the volume (Drbe, 90) constant to FTP. CONCLUSIONS: LETd painting offers a method to reduce prescribed dose at no cost to the biological effectiveness of the treatment.
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