TY - JOUR
T1 - Early experience with intensity modulated proton therapy for lung-intact mesothelioma
T2 - A case series
AU - Pan, Hubert Y.
AU - Jiang, Shengpeng
AU - Sutton, Jordan
AU - Liao, Zhongxing
AU - Chance, William W.
AU - Frank, Steven J.
AU - Zhu, X. Ronald
AU - Li, Heng
AU - Fontanilla, Hiral P.
AU - Zhang, Xiaodong
AU - Gomez, Daniel R.
N1 - Publisher Copyright:
© 2015 American Society for Radiation Oncology.
PY - 2015
Y1 - 2015
N2 - Purpose: The purpose of this study was to describe our experience implementing intensity modulated proton therapy (IMPT) for lung-intact malignant pleural mesothelioma (MPM), including patient selection, treatment planning, dose verification, and process optimization. Methods and materials: Seven patients with epithelioid MPM were reviewed; 6 underwent pleurectomy, whereas 1 had biopsy alone. Four patients received IMPT and 3 received intensity modulated radiation therapy. Treatment plans for the other modality were created for dosimetric comparisons. Quality assurance processes included dose verification and robustness analysis. Image-guided setup was performed with the first isocenter, and couch shifts were applied to reposition to the second isocenter. Results: Treatment with IMPT was well tolerated and completed without breaks. IMPT plans were designed with 2 isocenters, 4 beams, and ≤. 64 energy layers per beam. Dose verification processes were completed in 3 hours. Total daily treatment time was approximately 45 minutes (20 minutes for setup and 25 minutes for delivery). IMPT produced lower mean doses to the contralateral lung, heart, esophagus, liver, and ipsilateral kidney, with increased contralateral lung sparing when mediastinal boost was required for nodal disease. Conclusions: Our initial experience showed that IMPT was feasible for routine care of patients with lung-intact MPM.
AB - Purpose: The purpose of this study was to describe our experience implementing intensity modulated proton therapy (IMPT) for lung-intact malignant pleural mesothelioma (MPM), including patient selection, treatment planning, dose verification, and process optimization. Methods and materials: Seven patients with epithelioid MPM were reviewed; 6 underwent pleurectomy, whereas 1 had biopsy alone. Four patients received IMPT and 3 received intensity modulated radiation therapy. Treatment plans for the other modality were created for dosimetric comparisons. Quality assurance processes included dose verification and robustness analysis. Image-guided setup was performed with the first isocenter, and couch shifts were applied to reposition to the second isocenter. Results: Treatment with IMPT was well tolerated and completed without breaks. IMPT plans were designed with 2 isocenters, 4 beams, and ≤. 64 energy layers per beam. Dose verification processes were completed in 3 hours. Total daily treatment time was approximately 45 minutes (20 minutes for setup and 25 minutes for delivery). IMPT produced lower mean doses to the contralateral lung, heart, esophagus, liver, and ipsilateral kidney, with increased contralateral lung sparing when mediastinal boost was required for nodal disease. Conclusions: Our initial experience showed that IMPT was feasible for routine care of patients with lung-intact MPM.
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U2 - 10.1016/j.prro.2014.11.005
DO - 10.1016/j.prro.2014.11.005
M3 - Article
C2 - 25572666
AN - SCOPUS:84937162028
SN - 1879-8500
VL - 5
SP - e345-e353
JO - Practical radiation oncology
JF - Practical radiation oncology
IS - 4
ER -