The online version of this article (doi:10.1186/s13014-017-0866-0) contains supplementary material, which is available to authorized users.
Accepted for poster presentation during the Multidisciplinary Thoracic Cancers Symposium in March 2017
The aim of the present study was to compare the dose distribution generated from photon volumetric modulated arc therapy (VMAT), intensity modulated proton therapy (IMPT), and intensity modulated carbon ion therapy (IMCIT) in the delivery of hypo-fractionated thoracic radiotherapy.
Ten selected patients who underwent thoracic particle therapy between 2015 and 2016 were re-planned to receive a relative biological effectiveness (RBE) weighted dose of 60 Gy (i.e., GyE) in 15 fractions delivered with VMAT, IMPT, or IMCIT with the same optimization criteria. Treatment plans were then compared.
There were no significant differences in target volume dose coverage or dose conformity, except improved D95 was found with IMCIT compared with VMAT (p = 0.01), and IMCIT was significantly better than IMPT in all target volume dose parameters. Particle therapy led to more prominent lung sparing at low doses, and this result was most prominent with IMCIT (p < 0.05). Improved sparing of other thoracic organs at risk (OARs) was observed with particle therapy, and IMCIT further lowered the D1cc and D5cc for major blood vessels, as compared with IMPT (p = 0.01).
Although it was comparable to VMAT, IMCIT led to significantly better tumor target dose coverage and conformity than did IMPT. Particle therapy, compared with VMAT, improved thoracic OAR sparing. IMCIT, compared with IMPT, may further improve normal lung and major blood vessel sparing under limited respiratory motion.
Additional file 1: Measurement of dose heterogeneity for particle therapy. (DOC 27 kb)13014_2017_866_MOESM1_ESM.doc
Additional file 2: Table S1. Normal lung dose distribution. Table S2. Dose distribution for the heart and the esophagus. Table S3. Recalculated 4D (doses accumulated from 4D CT phases within the gating window) vs. 3D dose comparison for selected dose parameters for intensity modulated a) carbon ion therapy, and b) proton therapy with the Wilcoxon rank test. (DOC 114 kb)13014_2017_866_MOESM2_ESM.doc
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- Comparison of photon volumetric modulated arc therapy, intensity-modulated proton therapy, and intensity-modulated carbon ion therapy for delivery of hypo-fractionated thoracic radiotherapy
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