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

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dc.citation.firstpage276
dc.citation.issueNumber7
dc.citation.journalTitleJournal of Applied Clinical Medical Physics
dc.citation.lastpage285
dc.citation.volumeNumber22
dc.contributor.authorDougherty, Jingjing M.
dc.contributor.authorCastillo, Edward
dc.contributor.authorCastillo, Richard
dc.contributor.authorFaught, Austin M.
dc.contributor.authorPepin, Mark
dc.contributor.authorPark, Sean S.
dc.contributor.authorBeltran, Chris J.
dc.contributor.authorGuerrero, Thomas
dc.contributor.authorGrills, Inga
dc.contributor.authorVinogradskiy, Yevgeniy
dc.date.accessioned2021-08-05T15:51:51Z
dc.date.available2021-08-05T15:51:51Z
dc.date.issued2021
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.
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.
dc.identifier.digitalacm2-13323
dc.identifier.doihttps://doi.org/10.1002/acm2.13323
dc.identifier.urihttps://hdl.handle.net/1911/111134
dc.language.isoeng
dc.publisherWiley
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.
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.titleFunctional avoidance-based intensity modulated proton therapy with 4DCT derived ventilation imaging for lung cancer
dc.typeJournal article
dc.type.dcmiText
dc.type.publicationpublisher version
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