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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
[From image-guided radiotherapy to dose-guided radiotherapy]
G Cazoulat1, M Lesaunier, A Simon
1Inserm, U642, 35000 Rennes, France.
Summary
Image-guided radiotherapy requires dose estimation due to anatomical changes. Deformable registration accurately calculates cumulative doses, but clinical validation is needed before widespread use in cancer treatment.
Area of Science:
- Radiation Oncology
- Medical Imaging
- Computational Anatomy
Background:
- Image-guided radiotherapy (IGRT) utilizes cone-beam CT for tumor localization.
- Anatomical variations during treatment necessitate replanning and cumulative dose estimation.
- Non-rigid registration methods are crucial for accurately assessing dose distribution changes.
Observation:
- Deformable registration, specifically the Demons method, was employed to track anatomical changes.
- Cumulative dose calculations were performed for prostate and head and neck cancer patients.
- Dose distributions were interpolated and compared to the initially planned dose.
Findings:
- For prostate cancer, cumulative doses to the rectum and bladder exceeded planned levels, increasing toxicity risk.
- Head and neck cancer treatment showed parotid gland over-dosing by the 5th week, indicating a need for replanning.
- Deformable registration effectively estimated cumulative dose to anatomical structures.
Implications:
- Accurate cumulative dose estimation is vital for adaptive radiotherapy planning.
- Early detection of dose escalation can prevent treatment-related toxicities.
- Further validation of deformable registration techniques is required for clinical implementation.
