Improving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT)
Abstract Background and purpose This study aims to develop and validate a novel whole-body intensity-modulated proton therapy (IMPT) approach for total marrow/lymphatic irradiation (TMI/TMLI) and compare its efficacy to helical tomotherapy (HT). Materials and methods Whole-body IMPT plans were desig...
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-024-02572-w |
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| author | Dayananda Shamurailatpam Sharma Arjunan Manikandan Gaganpreet Singh Sanjib Gayen Sham Sundar Aishwarya G Rangasamy S Mahammood Suhail Rajesh S Ganapathy Krishnan Revathi Raj Srinivas Chilukuri Jose Easow Rakesh Jalali |
| author_facet | Dayananda Shamurailatpam Sharma Arjunan Manikandan Gaganpreet Singh Sanjib Gayen Sham Sundar Aishwarya G Rangasamy S Mahammood Suhail Rajesh S Ganapathy Krishnan Revathi Raj Srinivas Chilukuri Jose Easow Rakesh Jalali |
| author_sort | Dayananda Shamurailatpam Sharma |
| collection | DOAJ |
| description | Abstract Background and purpose This study aims to develop and validate a novel whole-body intensity-modulated proton therapy (IMPT) approach for total marrow/lymphatic irradiation (TMI/TMLI) and compare its efficacy to helical tomotherapy (HT). Materials and methods Whole-body IMPT plans were designed using five isocenters and fifteen fields for adult and three isocenters and eight fields for pediatric. Overlapping sub-PTVs were optimized to ensure robust and homogeneous dose distribution across consecutive isocenters and across CT datasets. Dosimetric benefits were compared to HT, safety and accuracy were verified using an in-house algorithm and planar dosage measurement. Results The average cranio-caudal and lateral whole-body PTV dimensions were 169.24 cm and 46.41 cm for five adults; 95.2 cm and 28.86 cm for one pediatric patient. IMPT plans provided adequate and homogeneous dose to all sub-PTVs, upper and lower body PTVs, with mean D95% ≥ 11.4 GyRBE. In comparison to HT, IMPT plans reduced mean integral dosage to normal tissue by 38%, OARs by a factor of 1.32 to 3.94, and V107% by 520.97 cc for sub-PTVs and 1166 cc for upper-body PTVs. For 38 pairs of planned and measured dosage planes at three depths, the average (± SD) gamma value was 96.77% (± 2.45%). Radiation ON time of 76 and 28 min for the tallest adult and pediatric patient plan was almost double HT plan of 39.9 and 14.1 min. Conclusion The presented whole-body IMPT approach for TMI/TMLI patients of any physical build-up is dosimetrically superior, safe and feasible to implement. Nevertheless, detailed robustness evaluation and cost-benefit analyses should guide its clinical implementation. |
| format | Article |
| id | doaj-art-33075d51fe5c4400bc344b22a143cb41 |
| institution | DOAJ |
| issn | 1748-717X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj-art-33075d51fe5c4400bc344b22a143cb412025-08-20T03:08:43ZengBMCRadiation Oncology1748-717X2025-05-0120111010.1186/s13014-024-02572-wImproving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT)Dayananda Shamurailatpam Sharma0Arjunan Manikandan1Gaganpreet Singh2Sanjib Gayen3Sham Sundar4Aishwarya G5Rangasamy S6Mahammood Suhail7Rajesh S8Ganapathy Krishnan9Revathi Raj10Srinivas Chilukuri11Jose Easow12Rakesh Jalali13Department of Medical Physics, Apollo Proton Cancer CentreDepartment of Medical Physics, Apollo Proton Cancer CentreDepartment of Medical Physics, Apollo Proton Cancer CentreDepartment of Medical Physics, Apollo Proton Cancer CentreDepartment of Radiation Oncology, Apollo Proton Cancer CentreDepartment of Medical Physics, Apollo Proton Cancer CentreDepartment of Medical Physics, Apollo Proton Cancer CentreDepartment of Medical Physics, Apollo Proton Cancer CentreDepartment of Medical Physics, Apollo Proton Cancer CentreDepartment of Medical Physics, Apollo Proton Cancer CentreDepartment of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Apollo Cancer CentreDepartment of Radiation Oncology, Apollo Proton Cancer CentreDepartment of Medical Oncology, Hematology, BMT and Cellular Therapy, Apollo Proton Cancer CentreDepartment of Radiation Oncology, Apollo Proton Cancer CentreAbstract Background and purpose This study aims to develop and validate a novel whole-body intensity-modulated proton therapy (IMPT) approach for total marrow/lymphatic irradiation (TMI/TMLI) and compare its efficacy to helical tomotherapy (HT). Materials and methods Whole-body IMPT plans were designed using five isocenters and fifteen fields for adult and three isocenters and eight fields for pediatric. Overlapping sub-PTVs were optimized to ensure robust and homogeneous dose distribution across consecutive isocenters and across CT datasets. Dosimetric benefits were compared to HT, safety and accuracy were verified using an in-house algorithm and planar dosage measurement. Results The average cranio-caudal and lateral whole-body PTV dimensions were 169.24 cm and 46.41 cm for five adults; 95.2 cm and 28.86 cm for one pediatric patient. IMPT plans provided adequate and homogeneous dose to all sub-PTVs, upper and lower body PTVs, with mean D95% ≥ 11.4 GyRBE. In comparison to HT, IMPT plans reduced mean integral dosage to normal tissue by 38%, OARs by a factor of 1.32 to 3.94, and V107% by 520.97 cc for sub-PTVs and 1166 cc for upper-body PTVs. For 38 pairs of planned and measured dosage planes at three depths, the average (± SD) gamma value was 96.77% (± 2.45%). Radiation ON time of 76 and 28 min for the tallest adult and pediatric patient plan was almost double HT plan of 39.9 and 14.1 min. Conclusion The presented whole-body IMPT approach for TMI/TMLI patients of any physical build-up is dosimetrically superior, safe and feasible to implement. Nevertheless, detailed robustness evaluation and cost-benefit analyses should guide its clinical implementation.https://doi.org/10.1186/s13014-024-02572-wIMPTTMITMLITBIDosimetryProton beam therapy |
| spellingShingle | Dayananda Shamurailatpam Sharma Arjunan Manikandan Gaganpreet Singh Sanjib Gayen Sham Sundar Aishwarya G Rangasamy S Mahammood Suhail Rajesh S Ganapathy Krishnan Revathi Raj Srinivas Chilukuri Jose Easow Rakesh Jalali Improving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT) Radiation Oncology IMPT TMI TMLI TBI Dosimetry Proton beam therapy |
| title | Improving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT) |
| title_full | Improving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT) |
| title_fullStr | Improving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT) |
| title_full_unstemmed | Improving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT) |
| title_short | Improving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT) |
| title_sort | improving total bone marrow and lymphoid irradiation feasibility of intensity modulated proton therapy impt and dosimetric comparison with helical tomotherapy ht |
| topic | IMPT TMI TMLI TBI Dosimetry Proton beam therapy |
| url | https://doi.org/10.1186/s13014-024-02572-w |
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