PMID- 25708992
OWN - NLM
STAT- MEDLINE
DCOM- 20150929
LR  - 20181202
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Print)
IS  - 0167-8140 (Linking)
VI  - 114
IP  - 3
DP  - 2015 Mar
TI  - Robust optimization in intensity-modulated proton therapy to account for anatomy 
      changes in lung cancer patients.
PG  - 367-72
LID - S0167-8140(15)00081-X [pii]
LID - 10.1016/j.radonc.2015.01.017 [doi]
AB  - BACKGROUND AND PURPOSE: Robust optimization for IMPT takes setup and range 
      uncertainties into account during plan optimization. However, anatomical changes 
      were not prospectively included. The purpose of this study was to examine 
      robustness and dose variation due to setup uncertainty and anatomical change in 
      IMPT of lung cancer. MATERIAL AND METHODS: Plans were generated with multi-field 
      optimization based on planning target volume (MFO-PTV) and worst-case robust 
      optimization (MFO-RO) on simulation computed tomography scans (CT0) for nine 
      patients. Robustness was evaluated on the CT0 by computing the standard deviation 
      of DVH (SD-DVH). Dose variations calculated on weekly CTs were compared with 
      SD-DVH. Equivalent uniform dose (EUD) change from the original plan on weekly 
      dose was also calculated for both plans. RESULTS: SD-DVH and dose variation on 
      weekly CTs were both significantly lower in the MFO-RO plans than in the MFO-PTV 
      plans for targets, lungs, and the esophagus (p<0.05). When comparing EUD for ITV 
      between weekly and planned dose distributions, three patients and 28% of repeated 
      CTs for MFO-RO plans, and six patients and 44% of repeated CTs for MFO-PTV plans, 
      respectively, showed an EUD change of >5%. CONCLUSIONS: RO in IMPT reduces the 
      dose variation due to setup uncertainty and anatomy changes during treatment 
      compared with PTV-based planning. However, dose variation could still be 
      substantial; repeated imaging and adaptive planning as needed are highly 
      recommended for IMPT of lung tumors.
CI  - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved.
FAU - Li, Heng
AU  - Li H
AD  - Department of Radiation Physics, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA. Electronic address: hengli@mdanderson.org.
FAU - Zhang, Xiaodong
AU  - Zhang X
AD  - Department of Radiation Physics, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
FAU - Park, Peter
AU  - Park P
AD  - Department of Radiation Physics, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
FAU - Liu, Wei
AU  - Liu W
AD  - Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, USA.
FAU - Chang, Joe
AU  - Chang J
AD  - Department of Radiation Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
FAU - Liao, Zhongxing
AU  - Liao Z
AD  - Department of Radiation Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
FAU - Frank, Steve
AU  - Frank S
AD  - Department of Radiation Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
FAU - Li, Yupeng
AU  - Li Y
AD  - Applied Research, Varian Medical Systems, Palo Alto, CA, USA.
FAU - Poenisch, Falk
AU  - Poenisch F
AD  - Department of Radiation Physics, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
FAU - Mohan, Radhe
AU  - Mohan R
AD  - Department of Radiation Physics, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
FAU - Gillin, Michael
AU  - Gillin M
AD  - Department of Radiation Physics, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
FAU - Zhu, Ronald
AU  - Zhu R
AD  - Department of Radiation Physics, The University of Texas MD Anderson Cancer 
      Center, Houston, TX, USA.
LA  - eng
GR  - K25 CA168984/CA/NCI NIH HHS/United States
GR  - P01 CA021239/CA/NCI NIH HHS/United States
GR  - P01CA021239/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20150220
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Humans
MH  - Lung Neoplasms/*pathology/*radiotherapy
MH  - Proton Therapy/*methods
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Tomography, X-Ray Computed
MH  - Uncertainty
PMC - PMC4400219
MID - NIHMS665232
OTO - NOTNLM
OT  - Adaptive planning
OT  - IMPT
OT  - Robust optimization
OT  - Robustness evaluation
COIS- Conflict of interest: None
EDAT- 2015/02/25 06:00
MHDA- 2015/09/30 06:00
PMCR- 2016/03/01
CRDT- 2015/02/25 06:00
PHST- 2014/06/27 00:00 [received]
PHST- 2014/12/26 00:00 [revised]
PHST- 2015/01/06 00:00 [accepted]
PHST- 2015/02/25 06:00 [entrez]
PHST- 2015/02/25 06:00 [pubmed]
PHST- 2015/09/30 06:00 [medline]
PHST- 2016/03/01 00:00 [pmc-release]
AID - S0167-8140(15)00081-X [pii]
AID - 10.1016/j.radonc.2015.01.017 [doi]
PST - ppublish
SO  - Radiother Oncol. 2015 Mar;114(3):367-72. doi: 10.1016/j.radonc.2015.01.017. Epub 
      2015 Feb 20.