Functional avoidance-based intensity modulated proton therapy with 4DCT derived ventilation imaging for lung cancer

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dc.citation.firstpage276en_US
dc.citation.issueNumber7en_US
dc.citation.journalTitleJournal of Applied Clinical Medical Physicsen_US
dc.citation.lastpage285en_US
dc.citation.volumeNumber22en_US
dc.contributor.authorDougherty, Jingjing M.en_US
dc.contributor.authorCastillo, Edwarden_US
dc.contributor.authorCastillo, Richarden_US
dc.contributor.authorFaught, Austin M.en_US
dc.contributor.authorPepin, Marken_US
dc.contributor.authorPark, Sean S.en_US
dc.contributor.authorBeltran, Chris J.en_US
dc.contributor.authorGuerrero, Thomasen_US
dc.contributor.authorGrills, Ingaen_US
dc.contributor.authorVinogradskiy, Yevgeniyen_US
dc.date.accessioned2021-08-05T15:51:51Zen_US
dc.date.available2021-08-05T15:51:51Zen_US
dc.date.issued2021en_US
dc.description.abstractThe primary objective is to evaluate the potential dosimetric gains of performing functional avoidance-based proton treatment planning using 4DCT derived ventilation imaging. 4DCT data of 31 patients from a prospective functional avoidance clinical trial were evaluated with intensity modulated proton therapy (IMPT) plans and compared with clinical volumetric modulated arc therapy (VMAT) plans. Dosimetric parameters were compared between standard and functional plans with IMPT and VMAT with one-way analysis of variance and post hoc paired student t-test. Normal Tissue Complication Probability (NTCP) models were employed to estimate the risk of two toxicity endpoints for healthy lung tissues. Dose degradation due to proton motion interplay effect was evaluated. Functional IMPT plans led to significant dose reduction to functional lung structures when compared with functional VMAT without significant dose increase to Organ at Risk (OAR) structures. When interplay effect is considered, no significant dose degradation was observed for the OARs or the clinical target volume (CTV) volumes for functional IMPT. Using fV20 as the dose metric and Grade 2+ pneumonitis as toxicity endpoint, there is a mean 5.7% reduction in Grade 2+ RP with the functional IMPT and as high as 26% in reduction for individual patient when compared to the standard IMPT planning. Functional IMPT was able to spare healthy lung tissue to avoid excess dose to normal structures while maintaining satisfying target coverage. NTCP calculation also shows that the risk of pulmonary complications can be further reduced with functional based IMPT.en_US
dc.identifier.citationDougherty, Jingjing M., Castillo, Edward, Castillo, Richard, et al.. "Functional avoidance-based intensity modulated proton therapy with 4DCT derived ventilation imaging for lung cancer." <i>Journal of Applied Clinical Medical Physics,</i> 22, no. 7 (2021) Wiley: 276-285. https://doi.org/10.1002/acm2.13323.en_US
dc.identifier.digitalacm2-13323en_US
dc.identifier.doihttps://doi.org/10.1002/acm2.13323en_US
dc.identifier.urihttps://hdl.handle.net/1911/111134en_US
dc.language.isoengen_US
dc.publisherWileyen_US
dc.rightsThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.titleFunctional avoidance-based intensity modulated proton therapy with 4DCT derived ventilation imaging for lung canceren_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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