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Biological optimization for hybrid proton-photon radiotherapy.

Wangyao Li1, Yuting Lin1, Harold H Li1

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Physics in Medicine and Biology
|May 17, 2024
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Summary

A new hybrid proton-photon radiotherapy planning method optimizes biological dose, reducing hot spots and improving organ-at-risk sparing compared to proton-only or photon-only treatments.

Keywords:
biologicaldosehybridoptimizationsphotonproton

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Area of Science:

  • Radiation oncology
  • Medical physics
  • Cancer treatment

Background:

  • Hybrid proton-photon radiotherapy (RT) aims to expand access to proton therapy.
  • Concerns exist regarding underestimation of proton biological dose effects on organs-at-risk (OARs).
  • Existing methods may not fully optimize plan quality for target coverage and OAR sparing under uncertainties.

Purpose of the Study:

  • Develop a hybrid RT planning method with biological dose optimization.
  • Ensure clinical implementability on existing proton and photon machines.
  • Achieve uniform target dose per fraction for both modalities.

Main Methods:

  • Optimized proton and photon plan variables and fraction numbers.
  • Minimized biological dose to OARs and surrounding tissues.
  • Used a probabilistic formulation for robust optimization against setup and range uncertainties.
  • Employed an iterative convex relaxation method to solve nonconvex optimization problems.

Main Results:

  • Hybrid planning with biological dose optimization eliminated biological dose hot spots in normal tissues.
  • Achieved superior overall plan quality and OAR sparing compared to proton-only or photon-only plans.
  • Demonstrated effective mitigation of biological dose underestimation.

Conclusions:

  • Presents a novel hybrid biological treatment planning method.
  • Offers reduced biological hot spots and superior plan quality.
  • Ensures clinical deliverability and robustness on existing RT machines.