Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymoma
Background and purpose: Proton Arc Therapy (PAT) is an emerging proton therapy treatment modality with the potential to reduce radiation exposure to healthy tissues compared to conventional Intensity-Modulated Proton Therapy (IMPT) with fewer beams. This is an attractive option for treating pediatri...
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| Language: | English |
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Medical Journals Sweden
2025-05-01
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| Series: | Acta Oncologica |
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| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/42001 |
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| author | Helge Henjum Karoline Mo Feten Erlend Hartvigsen Kristian S. Ytre-Hauge Camilla G. Boer Camilla H. Stokkevåg |
| author_facet | Helge Henjum Karoline Mo Feten Erlend Hartvigsen Kristian S. Ytre-Hauge Camilla G. Boer Camilla H. Stokkevåg |
| author_sort | Helge Henjum |
| collection | DOAJ |
| description | Background and purpose: Proton Arc Therapy (PAT) is an emerging proton therapy treatment modality with the potential to reduce radiation exposure to healthy tissues compared to conventional Intensity-Modulated Proton Therapy (IMPT) with fewer beams. This is an attractive option for treating pediatric patients, who are vulnerable to radiation-induced side effects. There is, however, a need to investigate the redistribution of dose to the target volume and organs at risk. In this study, we therefore explored the potential of PAT in proton therapy of pediatric ependymoma.
Methods and materials: Three-field IMPT and PAT treatment plans for 10 pediatric ependymoma patients were optimized using the Eclipse treatment planning system. The PAT plans consisted of 8 fields, spanning 170 degrees. Both modalities were robustly optimized with a ± 2 mm isocenter shift and a ± 3% range uncertainty.
Results: PAT showed improved CTV coverage compared to three-field IMPT, with a distinct increase in D98%. A clear dose reduction was found for the cochleae, with median values of 9.32 Gy(Relative Biological Effectiveness [RBE]) [0.76 – 30.40 Gy(RBE)] and 18.30 Gy(RBE) [1.24 – 29.75 Gy(RBE)] for PAT and IMPT, respectively, for the right cochlea. For the left cochlea, the respective doses were 12.34 Gy(RBE) [2.81 – 30.94 Gy(RBE)] and 18.49 Gy(RBE) [4.27 – 31.97 Gy(RBE)]. No significant difference for the brain integral dose was found between the two modalities.
Interpretation: PAT can improve the dosimetric outcome of proton therapy in pediatric ependymoma patients. Organs at risk dose varied on a patient-to-patient basis; thus, individual treatment plan comparisons are recommended.
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| format | Article |
| id | doaj-art-452fbf6ab08746a28edb2ae93ef01329 |
| institution | Kabale University |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-452fbf6ab08746a28edb2ae93ef013292025-08-20T03:52:46ZengMedical Journals SwedenActa Oncologica1651-226X2025-05-016410.2340/1651-226X.2025.42001Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymomaHelge Henjum0https://orcid.org/0000-0002-0142-8864Karoline Mo Feten1Erlend Hartvigsen2Kristian S. Ytre-Hauge3https://orcid.org/0000-0002-3597-1611Camilla G. Boer4https://orcid.org/0009-0001-0863-0993Camilla H. Stokkevåg5https://orcid.org/0000-0001-6352-4571Department of Physics and Technology, University of Bergen, Bergen, NorwayDepartment of Physics and Technology, University of Bergen, Bergen, NorwayDepartment of Physics and Technology, University of BergenDepartment of Physics and Technology, University of Bergen, Bergen, NorwayDepartment of Oncology and Medical Physics, Haukeland University Hospital, Bergen, NorwayDepartment of Physics and Technology, University of Bergen, Bergen, Norway; Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, NorwayBackground and purpose: Proton Arc Therapy (PAT) is an emerging proton therapy treatment modality with the potential to reduce radiation exposure to healthy tissues compared to conventional Intensity-Modulated Proton Therapy (IMPT) with fewer beams. This is an attractive option for treating pediatric patients, who are vulnerable to radiation-induced side effects. There is, however, a need to investigate the redistribution of dose to the target volume and organs at risk. In this study, we therefore explored the potential of PAT in proton therapy of pediatric ependymoma. Methods and materials: Three-field IMPT and PAT treatment plans for 10 pediatric ependymoma patients were optimized using the Eclipse treatment planning system. The PAT plans consisted of 8 fields, spanning 170 degrees. Both modalities were robustly optimized with a ± 2 mm isocenter shift and a ± 3% range uncertainty. Results: PAT showed improved CTV coverage compared to three-field IMPT, with a distinct increase in D98%. A clear dose reduction was found for the cochleae, with median values of 9.32 Gy(Relative Biological Effectiveness [RBE]) [0.76 – 30.40 Gy(RBE)] and 18.30 Gy(RBE) [1.24 – 29.75 Gy(RBE)] for PAT and IMPT, respectively, for the right cochlea. For the left cochlea, the respective doses were 12.34 Gy(RBE) [2.81 – 30.94 Gy(RBE)] and 18.49 Gy(RBE) [4.27 – 31.97 Gy(RBE)]. No significant difference for the brain integral dose was found between the two modalities. Interpretation: PAT can improve the dosimetric outcome of proton therapy in pediatric ependymoma patients. Organs at risk dose varied on a patient-to-patient basis; thus, individual treatment plan comparisons are recommended. https://medicaljournalssweden.se/actaoncologica/article/view/42001proton arc therapyintensity-modulated proton therapy (IMPT)Robust optimizationrobust evaluationlinear energy transfer |
| spellingShingle | Helge Henjum Karoline Mo Feten Erlend Hartvigsen Kristian S. Ytre-Hauge Camilla G. Boer Camilla H. Stokkevåg Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymoma Acta Oncologica proton arc therapy intensity-modulated proton therapy (IMPT) Robust optimization robust evaluation linear energy transfer |
| title | Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymoma |
| title_full | Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymoma |
| title_fullStr | Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymoma |
| title_full_unstemmed | Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymoma |
| title_short | Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymoma |
| title_sort | dosimetric comparison of intensity modulated proton therapy and proton arc therapy for pediatric ependymoma |
| topic | proton arc therapy intensity-modulated proton therapy (IMPT) Robust optimization robust evaluation linear energy transfer |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/42001 |
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