To evaluate the dosimetric consequences of rotational and translational alignment errors in patients receiving intensity-modulated proton therapy with multifield optimization (MFO-IMPT) for prostate cancer.
Ten control patients with localized prostate cancer underwent treatment planning for MFO-IMPT. Rotational and translation errors were simulated along each of 3 axes: anterior-posterior (A-P), superior-inferior (S-I), and left-right. Clinical target-volume (CTV) coverage remained high with all alignment errors simulated. Rotational errors did not result in significant rectum or bladder dose perturbations. Translational errors resulted in larger dose perturbations to the bladder and rectum. Perturbations in rectum and bladder doses were minimal for rotational errors and larger for translational errors. Rectum V45 and V70 increased most with A-P misalignment, whereas bladder V45 and V70 changed most with S-I misalignment. The bladder and rectum V45 and V70 remained acceptable even with extreme alignment errors. Even with S-I and A-P translational errors of up to 5mm, the dosimetric profile of MFO-IMPT remained favorable. MFO-IMPT for localized prostate cancer results in robust coverage of the CTV without clinically meaningful dose perturbations to normal tissue despite extreme rotational and translational alignment errors.
Written by:
Pugh TJ, Amos RA, John Baptiste S, Choi S, Nhu Nguyen Q, Ronald Zhu X, Palmer MB, Lee AK. Are you the author?
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Reference: Med Dosim. 2013 Jun 6. pii: S0958-3947(13)00043-5.
doi: 10.1016/j.meddos.2013.03.007
PubMed Abstract
PMID: 23747223
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