Abstract
Background: We assessed the robustness of passive scattering proton therapy (PSPT) plans for patients in a phase II trial of PSPT for stage III non-small cell lung cancer (NSCLC) by using the worst-case scenario method, and compared the worst-case dose distributions with the appearance of locally recurrent lesions.Methods: Worst-case dose distributions were generated for each of 9 patients who experienced recurrence after concurrent chemotherapy and PSPT to 74 Gy(RBE) for stage III NSCLC by simulating and incorporating uncertainties associated with set-up, respiration-induced organ motion, and proton range in the planning process. The worst-case CT scans were then fused with the positron emission tomography (PET) scans to locate the recurrence.Results: Although the volumes enclosed by the prescription isodose lines in the worst-case dose distributions were consistently smaller than enclosed volumes in the nominal plans, the target dose coverage was not significantly affected: only one patient had a recurrence outside the prescription isodose lines in the worst-case plan.Conclusions: PSPT is a relatively robust technique. Local recurrence was not associated with target underdosage resulting from estimated uncertainties in 8 of 9 cases.
Original language | English (US) |
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Article number | 108 |
Journal | Radiation Oncology |
Volume | 9 |
Issue number | 1 |
DOIs | |
State | Published - May 6 2014 |
Keywords
- Non-small cell lung cancer
- Passive scattering proton therapy
- Proton therapy
- Robustness analysis
- Worst-case scenario method
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
MD Anderson CCSG core facilities
- Clinical Trials Office