Publications (2)4.85 Total impact
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Article: SU-E-J-214: Target Intrafraction Motion Dosimetric Impact on 5-Fraction Proton Prostate SBRT.
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ABSTRACT: Purpose: To investigate dosimetric impact of prostate intra-fraction motion to five fraction hypofractionated proton treatment with uniform scanning (US) and double scattering (DS) techniques using real-time prostate tracking data from electromagnetic transponder system. Methods: Prostate intra-fraction motion can have spatiotemporal interplay with proton treatment delivery. Five fraction (7.25Gy/fraction) prostate proton stereotactic body radiotherapy (SBRT) treatments were simulated for total 14 patients using in-house proton treatment simulation program. The US treatment was simulated by rigidly moving CTV through a series of temporal-spatial dose matrices indexed by energy layers, according to prostate motion traces. The CTV temporal doses of the whole treatment fraction were obtained and summed as final prostate CTV dose. The DS treatment was simulated by moving CTV through the energy layer summed dose matrix. For all patients, the fraction doses and the total dose to the CTV were presented for both DS and US treatments. Results: The CTV dose of different fractions indicated that its dose degradation depends on magnitude and direction of prostate intra-fraction motion and is patient specific. For one of the prostate motion traces investigated, only 70% of CTV received 100% prescribed dose for a simulated US treatment and 79% CTV had 100% dose for a DS treatment. Furthermore, DVH and isodose graphs of both treatments revealed that intra-fraction motion caused significant CTV cold and hot spots in US treatment whereas only cause CTV underdose in DS treatment. Conclusions: Intra-fraction prostate motion causes dose uncertainty to CTV. In the 5 fraction prostate SBRT, prostate intra-fraction motion causes significant target dose degradation. In US treatment, spatiotemporal interplay between energy layers delivery and prostate motion leads to hot and cold spots in CTV for some patients with severe prostate intra-fraction motion. Further investigation of intra-fraction motion management and its impact on CTV dose is necessary.Medical Physics 06/2012; 39(6):3702. · 2.83 Impact Factor -
Article: Protons safely allow coverage of high-risk nodes for patients with regionally advanced non-small-cell lung cancer.
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ABSTRACT: Our objective was to determine if protons allow for the expansion of treatment volumes to cover high-risk nodes in patients with regionally advanced non-small-cell lung cancer. In this study, 5 consecutive patients underwent external-beam radiotherapy treatment planning. Four treatment plans were generated for each patient: 1) photons (x-rays) to treat positron emission tomography (PET)-positive gross disease only to 74 Gy (XG); 2) photons (x-rays) to treat high-risk nodes to 44 Gy and PET-positive gross disease to 74 Gy (XNG); 3) protons to treat PET-positive gross disease only to 74 cobalt gray equivalent (PG); and 4) protons to treat high-risk nodes to 44 CGE and PET-positive gross disease to 74 CGE (PNG). We defined high-risk nodes as mediastinal, hilar, and supraclavicular lymph nodal stations anatomically adjacent to the foci of PET-positive gross disease. Four-dimensional computed tomography was utilized for all patients to account for tumor motion. Standard normal-tissue constraints were utilized. Our results showed that proton plans for all patients were isoeffective with the corresponding photon (x-ray) plans in that they achieved the desired target doses while respecting normal-tissue constraints. In spite of the larger volumes covered, median volume of normal lung receiving 10 CGE or greater (V10Gy/CGE), median V20Gy/CGE, and mean lung dose were lower in the proton plans (PNG) targeting gross disease and nodes when compared with the photon (x-ray) plans (XG) treating gross disease alone. In conclusion, proton plans demonstrated the potential to safely include high-risk nodes without increasing the volume of normal lung irradiated when compared to photon (x-ray) plans, which only targeted gross disease.Technology in cancer research & treatment 08/2011; 10(4):317-22. · 2.02 Impact Factor
