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Comparison between 4D robust optimization methods for carbon-ion treatment planning

Nuclear Science and Techniques 2023年第9期34卷 94-105页

作者： Wen-Yu Wang Yuan-Yuan Ma Hui Zhang Xin-Yang Zhang Jing-Fen Yang Xin-Guo Liu Qiang Li Institute of Modern Physics Chinese Academy of SciencesLanzhou 73000China Key Laboratory of Heavy Ion Radiation Biology and Medicine of Chinese Academy of Science Lanzhou 730000China Gansu Provincial Key Laboratory of Basic Research on Heavy Ion Radiation Application in Medicine Lanzhou 730000China University of Chinese Academy of Sciences Beijing 100049China Putian Lanhai Nuclear Medicine Research Center Putian 351152China

intensity-modulated particle therapy(IMPT)with carbon ions is comparatively susceptible to various uncertainties caused by breathing motion,including range,setup,and target positioning *** determine relative biological effectiveness-weighted dose(RWD)distributions that are resilient to these uncertainties,the reference phase-based four-dimensional(4D)robust optimization(RP-4DRO)and each phase-based 4D robust optimization(EP-4DRO)method in carbon-ion IMPT treatment planning were evaluated and *** on RWD distributions,4DRO methods were compared with 4D conventional optimization using planning target volume(PTV)margins(PTV-based optimization)to assess the effectiveness of the robust optimization ***-ion IMPT treatment planning was conducted in a cohort of five lung cancer *** results indicated that the EP-4DRO method provided better robustness(P=0.080)and improved plan quality(P=0.225)for the clinical target volume(CTV)in the individual respiratory phase when compared with the PTV-based *** with the PTV-based optimization,the RP-4DRO method ensured the robustness(P=0.022)of the dose distributions in the reference breathing phase,albeit with a slight sacrifice of the target coverage(P=0.450).Both 4DRO methods successfully maintained the doses delivered to the organs at risk(OARs)below tolerable levels,which were lower than the doses in the PTV-based optimization(P<0.05).Furthermore,the RP-4DRO method exhibited significantly superior performance when compared with the EP-4DRO method in enhancing overall OAR sparing in either the individual respiratory phase or reference respiratory phase(P<0.05).In general,both 4DRO methods outperformed the PTV-based optimization in terms of OAR sparing and robustness.

关键词： intensity-modulated particle therapy Carbon-ion radiotherapy Uncertainties Four-dimensional robust optimization Lung cancer Relative biological effectiveness-weighted dose Robustness Treatment planning system

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