PMID- 35965505
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231115
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - Treatment planning of total marrow irradiation with intensity-modulated 
      spot-scanning proton therapy.
PG  - 955004
LID - 10.3389/fonc.2022.955004 [doi]
LID - 955004
AB  - PURPOSE: The goal of this study is to investigate treatment planning of total 
      marrow irradiation (TMI) using intensity-modulated spot-scanning proton therapy 
      (IMPT). The dosimetric parameters of the intensity-modulated proton plans were 
      evaluated and compared with the corresponding TMI plans generated with volumetric 
      modulated arc therapy (VMAT) using photon beams. METHODS: Intensity-modulated 
      proton plans for TMI were created using the Monte Carlo dose-calculation 
      algorithm in the Raystation 11A treatment planning system with spot-scanning 
      proton beams from the MEVION S250i Hyperscan system. Treatment plans were 
      generated with four isocenters placed along the longitudinal direction, each with 
      a set of five beams for a total of 20 beams. VMAT-TMI plans were generated with 
      the Eclipse-V15 analytical anisotropic algorithm (AAA) using a Varian Trilogy 
      machine. Three planning target volumes (PTVs) for the bones, ribs, and spleen 
      were covered by 12 Gy. The dose conformity index, D80, D50, and D10, for PTVs and 
      organs at risk (OARs) for the IMPT plans were quantified and compared with the 
      corresponding VMAT plans. RESULTS: The mean dose for most of the OARs was reduced 
      substantially (5% and more) in the IMPT plans for TMI in comparison with VMAT 
      plans except for the esophagus and thyroid, which experienced an increase in 
      dose. This dose reduction is due to the fast dose falloff of the distal Bragg 
      peak in the proton plans. The conformity index was found to be similar (0.78 vs 
      0.75) for the photon and proton plans. IMPT plans provided superior superficial 
      dose coverage for the skull and ribs in comparison with VMAT because of increased 
      entrance dose deposition by the proton beams. CONCLUSION: Treatment plans for TMI 
      generated with IMPT were superior to VMAT plans mainly due to a large reduction 
      in the OAR dose. Although the current IMPT-TMI technique is not clinically 
      practical due to the long overall treatment time, this study presents an enticing 
      alternative to conventional TMI with photons by providing superior dose coverage 
      of the targets, increased sparing of the OARs, and enhanced radiobiological 
      effects associated with proton therapy.
CI  - Copyright (c) 2022 Zuro, Vidal, Cantrell, Chen, Han, Henson, Ahmad, Hui and Ali.
FAU - Zuro, Darren M
AU  - Zuro DM
AD  - Department of Radiation Oncology, University of Oklahoma Health Science Center 
      (HSC), Oklahoma City, OK, United States.
FAU - Vidal, Gabriel
AU  - Vidal G
AD  - Department of Radiation Oncology, University of Oklahoma Health Science Center 
      (HSC), Oklahoma City, OK, United States.
FAU - Cantrell, James Nathan
AU  - Cantrell JN
AD  - Department of Radiation Oncology, University of Oklahoma Health Science Center 
      (HSC), Oklahoma City, OK, United States.
FAU - Chen, Yong
AU  - Chen Y
AD  - Department of Radiation Oncology, University of Oklahoma Health Science Center 
      (HSC), Oklahoma City, OK, United States.
FAU - Han, Chunhui
AU  - Han C
AD  - Department of Radiation Oncology, City of Hope, Durate, CA, United States.
FAU - Henson, Christina
AU  - Henson C
AD  - Department of Radiation Oncology, University of Oklahoma Health Science Center 
      (HSC), Oklahoma City, OK, United States.
FAU - Ahmad, Salahuddin
AU  - Ahmad S
AD  - Department of Radiation Oncology, University of Oklahoma Health Science Center 
      (HSC), Oklahoma City, OK, United States.
FAU - Hui, Susanta
AU  - Hui S
AD  - Department of Radiation Oncology, City of Hope, Durate, CA, United States.
FAU - Ali, Imad
AU  - Ali I
AD  - Department of Radiation Oncology, University of Oklahoma Health Science Center 
      (HSC), Oklahoma City, OK, United States.
LA  - eng
GR  - R01 CA154491/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20220728
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9365973
OTO - NOTNLM
OT  - dosimetric analyses
OT  - proton radiation therapy
OT  - radiation therapy
OT  - total marrow irradiation (TMI)
OT  - volumetric arc radiotherapy
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/08/16 06:00
MHDA- 2022/08/16 06:01
PMCR- 2022/01/01
CRDT- 2022/08/15 03:25
PHST- 2022/05/27 00:00 [received]
PHST- 2022/07/05 00:00 [accepted]
PHST- 2022/08/15 03:25 [entrez]
PHST- 2022/08/16 06:00 [pubmed]
PHST- 2022/08/16 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.955004 [doi]
PST - epublish
SO  - Front Oncol. 2022 Jul 28;12:955004. doi: 10.3389/fonc.2022.955004. eCollection 
      2022.