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Development and Validation of Single Field Multi-Ion Particle Therapy Treatments.

单场多离子粒子治疗的开发和验证。

  • 影响因子:3.70
  • DOI:10.1016/j.ijrobp.2019.10.008
  • 作者列表:"Kopp B","Mein S","Dokic I","Harrabi S","Böhlen TT","Haberer T","Debus J","Abdollahi A","Mairani A
  • 发表时间:2020-01-01
Abstract

PURPOSE:To develop and validate combined ion-beam with constant relative biological effectiveness (RBE) (CICR) particle therapy in single field arrangements for improved treatment efficacy, robustness, and normal tissue sparing. METHODS AND MATERIALS:The PRECISE (PaRticle thErapy using single and Combined Ion optimization StratEgies) treatment planning system was developed to investigate clinical viability of CICR treatments. Single-field uniform dose (SFUD) with a single ion (proton [p], helium [He], or carbon [C]) and CICR (C-p and C-He) treatments were generated for 3 patient cases with a clinically prescribed dose of 3 Gy (RBE) per fraction. Spread-out Bragg peak plans were irradiated in homogenous and clinical-like settings using an anthropomorphic head phantom. A dosimetric and biological verification of CICRC-p treatments using a murine glioma cell line (GL261) was performed. RESULTS:CICR treatment plans for the 3 patients presented highly uniform physical dose while reducing high dose-averaged linear energy transfer gradients compared with carbon ions alone. When considering uncertainty in tissue parameter (α/β)x assignment and RBE modeling, the CICRC-p treatment exhibited enhanced biophysical stability within the target volume, similar to protons alone. CICR treatments reduced dose to normal tissue surrounding the target, exhibiting similar or improved dosimetric features compared with SFUDHe. For both CICRC-p and SFUD treatments, measurements verified the planned dose in the target within ∼3%. Planned versus measured target RBE values were 1.38 ± 0.02 and 1.39 ± 0.07 (<1% deviation), respectively, for the CICRC-p treatment in heterogenous settings. CONCLUSIONS:Here, we demonstrate that by combining 2 (or more) ions in a single field arrangement, more robust biological and more conformal dose distributions can be delivered compared with conventional particle therapy treatment planning. This work constitutes the first dosimetric and biological verification of multi-ion particle therapy in homogeneous as well as heterogenous settings.

摘要

目的: 在单野布置中开发和验证具有恒定相对生物有效性 (RBE) (CICR) 粒子治疗的联合离子束,以改善治疗效果、稳健性和正常组织保留。 方法和材料: 开发了精确 (使用单一和联合离子优化策略的粒子治疗) 治疗计划系统,以研究CICR治疗的临床可行性。单场均匀剂量 (sfod) 与单离子 (质子 [p],氦 [He],或碳 [C]) 和CICR (C-p和C-He) 对 3 例患者病例进行了治疗,临床处方剂量为每部分 3 Gy (RBE)。使用拟人头体模在同质和临床样环境中照射散开的Bragg峰计划。使用鼠胶质瘤细胞系 (GL261) 进行CICRC-p治疗的剂量学和生物学验证。 结果: 与单纯碳离子相比,3 例患者的CICR治疗计划呈现高度均匀的物理剂量,同时降低高剂量平均线性能量转移梯度。当考虑组织参数 (α/β)x分配和RBE建模的不确定性时,CICRC-p治疗在靶体积内表现出增强的生物物理稳定性,类似于单独的质子。CICR治疗减少了靶区周围正常组织的剂量,与SFUDHe相比表现出相似或改善的剂量学特征。对于CICRC-p和SFUD治疗,测量值验证了目标中的计划剂量在 3% 以内。异源环境下CICRC-p治疗的计划与测量目标RBE值分别为 1.38 ± 0.02 和 1.39 ± 0.07 (偏差 <1%)。 结论: 在这里,我们证明了通过在单个场排列中结合 2 个 (或更多) 离子,与常规粒子治疗治疗计划相比,可以提供更稳健的生物和更适形剂量分布。这项工作构成了多离子粒子治疗在均质和异种环境中的首次剂量学和生物学验证。

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

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影响因子:2.83
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DOI:10.1007/s00520-019-04843-9
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