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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Range uncertainty in proton therapy due to variable biological effectiveness.

Alejandro Carabe1, Maryam Moteabbed, Nicolas Depauw

  • 1Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. a.carabe@uphs.upenn.edu

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Proton radiotherapy dose prescription can vary due to relative biological effectiveness (RBE). This study quantifies how RBE variations affect proton beam range, crucial for accurate cancer treatment planning.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Biophysical Modeling

Background:

  • Proton radiotherapy dose is traditionally prescribed using a fixed relative biological effectiveness (RBE) of 1.1.
  • Proton RBE is known to vary with dose-averaged linear energy transfer (LET(d)), dose, and the alpha-beta ratio ((α/β)(x)).
  • This RBE variation can alter the proton beam's range, impacting treatment precision.

Purpose of the Study:

  • To quantify the dependence of proton beam range shifts on dose, (α/β)(x), and initial beam energy.
  • To investigate the impact of variable RBE on dose distributions in proton radiotherapy.

Main Methods:

  • Utilized Monte Carlo simulations to determine LET(d) distributions in a computational phantom with varying (α/β)(x) values.
  • Calculated variable RBE values using an in-house biophysical model for doses ranging from 1 to 15 Gy.
  • Compared range differences between fixed (RBE=1.1) and variable RBE calculations using dose-volume histograms.

Main Results:

  • Range shifts of 2-3 mm were observed in normal tissue for shallow and deep beams at 1 Gy.
  • Increasing dose to 15 Gy resulted in shorter ranges (approx. 1 mm) with variable RBE compared to fixed RBE.
  • The range shift increases with initial beam range but decreases with increasing dose or (α/β)(x).

Conclusions:

  • The study provides quantitative data on RBE-induced range uncertainties in proton therapy.
  • These findings are essential for accurate treatment planning, considering variations based on treatment site and dose.
  • Accurate RBE modeling is critical for optimizing proton beam range and ensuring effective dose delivery.