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Quantifying Systematic RBE-Weighted Dose Uncertainty Arising from Multiple Variable RBE Models in Organ at Risk.
Wei Yang Calvin Koh1,2, Hong Qi Tan2, Yan Yee Ng2
1Division of Physics and Applied Physics, Nanyang Technological University, Singapore.
Multi-field optimization (MFO) planning is recommended over single-field optimization (SFO) for brain tumors overlapping organs at risk (OARs). MFO planning effectively reduces relative biological effectiveness (RBE)-weighted dose uncertainties, improving treatment plan reliability.
Area of Science:
- Medical Physics
- Radiation Oncology
- Biophysics
Background:
- Proton therapy planning faces challenges due to relative biological effectiveness (RBE) uncertainties, especially near organs at risk (OARs).
- Variable RBE models are preferred over constant RBE values for complex treatment sites.
- Current RBE models introduce uncertainties, necessitating comparative studies for clinical application.
Purpose of the Study:
- To evaluate the influence of different RBE models on proton therapy treatment plan outcomes.
- To quantify RBE-weighted dose uncertainties in OARs when target volumes overlap with OARs.
- To compare multi-field optimization (MFO) and single-field optimization (SFO) techniques for their efficacy in reducing RBE-related uncertainties.
Main Methods:
- Analyzed 6 RBE models for 15 brain tumor patients with target volumes overlapping the brain stem and optic chiasm.
- Calculated RBE-weighted dose uncertainties in OARs for both MFO and SFO plans at 3 Gy and 8 Gy.
- Investigated the relationship between linear energy transfer (LET) distribution and RBE-weighted dose uncertainties using statistical analysis.
Main Results:
- MFO planning demonstrated significantly lower RBE-weighted dose uncertainties in OARs compared to SFO planning for most patients.
- MFO planning resulted in lower mean LET in the optic chiasm and brain stem for a majority of patients.
- No single RBE model definitively predicted treatment plan success or failure.
Conclusions:
- Multi-field optimization (MFO) is superior to single-field optimization (SFO) in minimizing RBE-weighted dose uncertainties for brain tumors overlapping OARs.
- MFO planning is recommended to enhance the reliability of proton therapy treatment plans in such clinical scenarios.
- Further research is needed to refine RBE models and their integration into treatment planning optimization.
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