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Contour-based lung dose prediction for breast proton therapy.

Chuan Zeng1, Kevin Sine1, Dennis Mah1

  • 1ProCure Proton Therapy Center, Somerset, NJ, USA.

Journal of Applied Clinical Medical Physics
|August 25, 2018
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Summary

This study developed a contour-based model to predict lung dose in breast cancer proton therapy. The model accurately estimates dose-volume metrics before treatment planning, aiding in setting realistic clinical goals.

Keywords:
breast cancerdose predictionradiation therapy

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Proton Therapy

Background:

  • Proton therapy offers potential advantages for breast cancer treatment due to precise dose deposition.
  • Accurate prediction of dose to organs at risk, such as the lungs, is crucial for minimizing toxicity.
  • Current methods for dose prediction can be time-consuming and may not be available early in the planning process.

Purpose of the Study:

  • To evaluate the feasibility of predicting lung dose based on patient anatomy and target contours in breast cancer patients undergoing proton therapy.
  • To establish a relationship between planning target volume (PTV) expansion margins and the resulting dose to the ipsilateral lung.
  • To develop a model that enables early dose prediction for treatment planning optimization.

Main Methods:

  • A retrospective analysis of 52 breast cancer patients treated with proton therapy was performed.
  • Isotropic expansions of the PTV with varying margins were created and compared to isodose volumes in the ipsilateral lung.
  • A mathematical model (V_D = V(m)) was established to correlate PTV expansion margin (m) with predicted lung dose-volume metrics (V_D).

Main Results:

  • The model demonstrated clinically relevant accuracy in predicting lung dose-volume metrics.
  • A PTV expansion of 1.1 cm accurately predicted V20 Gy(RBE) with a 5% root-mean-square deviation (RMSD).
  • A PTV expansion of 2.2 cm accurately predicted V5 Gy(RBE) with a 6% RMSD.

Conclusions:

  • A contour-based model for predicting ipsilateral lung dose in breast proton therapy was successfully established.
  • The model provides accurate, clinically relevant dose predictions prior to detailed treatment planning.
  • This tool can assist in setting achievable clinical goals and optimizing treatment plans for breast cancer patients.