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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
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Robust mixed electron-photon radiation therapy optimization.

Marc-André Renaud1, Monica Serban2, Jan Seuntjens3

  • 1Department of Physics & Medical Physics Unit, McGill University, Montreal, Canada.

Medical Physics
|January 11, 2019
PubMed
Summary
This summary is machine-generated.

Robust optimization is critical for mixed beam electron-photon radiation therapy (MBRT) plans. New CTV-based robust plans maintain target coverage under positioning errors, unlike traditional PTV-based plans which show significant degradation.

Keywords:
column Generationmixed beam radiation therapymodulated electron radiation therapyrobust Optimisationtreatment Planning

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Cancer Treatment

Background:

  • Mixed beam electron-photon radiation therapy (MBRT) offers potential for improved dose distribution in superficial tumors.
  • Advances in technology enable complex MBRT plan delivery without specialized equipment.
  • Robustness of MBRT plans to patient setup errors has not been previously studied.

Purpose of the Study:

  • Assess the sensitivity of traditional MBRT plans to patient positioning uncertainties.
  • Develop and evaluate a novel optimization model for robust MBRT plan creation.

Main Methods:

  • Applied column generation to robust MBRT planning using stochastic and minimax models.
  • Generated beamlet dose distributions for electron and photon beams under various positioning shifts.
  • Created robust plans using clinical target volume (CTV) constraints, contrasting with traditional planning target volume (PTV) based plans.

Main Results:

  • Traditional PTV-based MBRT plans showed degraded target coverage homogeneity with positioning errors.
  • Cold and hot spots within the clinical target volume (CTV) occurred in PTV-based plans with 5mm shifts.
  • New CTV-based robust plans maintained target coverage within 95%-108% limits for all positioning errors.

Conclusions:

  • MBRT plan quality is highly sensitive to patient positioning errors with traditional PTV-based optimization.
  • Positioning errors rendered traditional PTV-based plans clinically unacceptable.
  • Robust optimization using CTV-based constraints is critical for ensuring MBRT dose distribution fidelity.