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Strahlentherapie und Onkologie

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Open Access 01-02-2015 | Original article

Comparison of 3D and 4D Monte Carlo optimization in robotic tracking stereotactic body radiotherapy of lung cancer

Authors: Mark K.H. Chan, M.Sc., Rene Werner, Ph.D., Miriam Ayadi, Ph.D., Oliver Blanck, Ph.D.

Published in: Strahlentherapie und Onkologie | Issue 2/2015

Abstract

Purpose

To investigate the adequacy of three-dimensional (3D) Monte Carlo (MC) optimization (3DMCO) and the potential of four-dimensional (4D) dose renormalization (4DMC_renorm) and optimization (4DMCO) for CyberKnife (Accuray Inc., Sunnyvale, CA) radiotherapy planning in lung cancer.

Materials and methods

For 20 lung tumors, 3DMCO and 4DMCO plans were generated with planning target volume (PTV_5 mm) = gross tumor volume (GTV) plus 5 mm, assuming 3 mm for tracking errors (PTV_3 mm) and 2 mm for residual organ deformations. Three fractions of 60 Gy were prescribed to ≥ 95 % of the PTV_5 mm. Each 3DMCO plan was recalculated by 4D MC dose calculation (4DMC_recal) to assess the dosimetric impact of organ deformations. The 4DMC_recal plans were renormalized (4DMC_renorm) to 95 % dose coverage of the PTV_5 mm for comparisons with the 4DMCO plans. A 3DMCO plan was considered adequate if the 4DMC_recal plan showed ≥ 95 % of the PTV_3 mm receiving 60 Gy and doses to other organs at risk (OARs) were below the limits.

Results

In seven lesions, 3DMCO was inadequate, providing < 95 % dose coverage to the PTV_3 mm. Comparison of 4DMC_recal and 3DMCO plans showed that organ deformations resulted in lower OAR doses. Renormalizing the 4DMC_recal plans could produce OAR doses higher than the tolerances in some 4DMC_renorm plans. Dose conformity of the 4DMC_renorm plans was inferior to that of the 3DMCO and 4DMCO plans. The 4DMCO plans did not always achieve OAR dose reductions compared to 3DMCO and 4DMC_renorm plans.

Conclusion

This study indicates that 3DMCO with 2 mm margins for organ deformations may be inadequate for Cyberknife-based lung stereotactic body radiotherapy (SBRT). Renormalizing the 4DMC_recal plans could produce degraded dose conformity and increased OAR doses; 4DMCO can resolve this problem.

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Title: Comparison of 3D and 4D Monte Carlo optimization in robotic tracking stereotactic body radiotherapy of lung cancer
Authors: Mark K.H. Chan, M.Sc.
Rene Werner, Ph.D.
Miriam Ayadi, Ph.D.
Oliver Blanck, Ph.D.
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 2/2015
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0747-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Comparison of 3D and 4D Monte Carlo optimization in robotic tracking stereotactic body radiotherapy of lung cancer

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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