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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Dosimetric changes resulting from patient rotational setup errors in proton therapy prostate plans.

Samir V Sejpal1, Richard A Amos, Jaques B Bluett

  • 1Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA.

International Journal of Radiation Oncology, Biology, Physics
|December 9, 2008
PubMed
Summary

Prostate cancer patients undergoing proton therapy experienced minimal dose changes to tumors and critical organs, even with up to 5-degree rotational setup errors and horizontal shifts. These findings suggest proton therapy is robust against common patient positioning variations.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Proton Therapy

Background:

  • Proton therapy offers precise dose delivery for prostate cancer.
  • Patient setup variations, including rotational errors, can impact treatment accuracy.
  • Evaluating these variations is crucial for ensuring treatment efficacy and safety.

Purpose of the Study:

  • To assess dose alterations in the clinical target volume (CTV) and organs at risk (OARs) due to rotational setup errors in prostate cancer patients treated with proton therapy.
  • To quantify the impact of simulated pelvic tilt and longitudinal setup variability on dose distribution.

Main Methods:

  • Analysis of 70 treatment plans for 10 prostate cancer patients receiving proton therapy.
  • Generation of rotational setup errors (+/-3, +/-5 degrees) and horizontal couch shifts (+/-3 degrees).
  • Recomputation of verification plans with identical treatment parameters to assess dose changes.

Main Results:

  • Mean CTV dose was 7,780 cGy-equivalent (CcGE).
  • Maximum mean dose change to CTV was 2 CcGE; critical organs showed mean changes up to 141 CcGE (femoral heads), generally <5% of total dose.
  • Volume deviations for bladder and rectum at 45 and 70 Gy were <2%.

Conclusions:

  • Patient rotational movements up to 5 degrees and horizontal shifts up to 3 degrees do not result in clinically significant dose changes to the target or critical structures in prostate proton therapy.
  • Proton therapy for prostate cancer demonstrates robustness against common setup variations.