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Open Access 01-12-2018 | Research

Proton and helium ion radiotherapy for meningioma tumors: a Monte Carlo-based treatment planning comparison

Authors: Thomas Tessonnier, Andrea Mairani, Wenjing Chen, Paola Sala, Francesco Cerutti, Alfredo Ferrari, Thomas Haberer, Jürgen Debus, Katia Parodi

Published in: Radiation Oncology | Issue 1/2018

Abstract

Background

Due to their favorable physical and biological properties, helium ion beams are increasingly considered a promising alternative to proton beams for radiation therapy. Hence, this work aims at comparing in-silico the treatment of brain and ocular meningiomas with protons and helium ions, using for the first time a dedicated Monte Carlo (MC) based treatment planning engine (MCTP) thoroughly validated both in terms of physical and biological models.

Methods

Starting from clinical treatment plans of four patients undergoing proton therapy with a fixed relative biological effectiveness (RBE) of 1.1 and a fraction dose of 1.8 Gy(RBE), new treatment plans were optimized with MCTP for both protons (with variable and fixed RBE) and helium ions (with variable RBE) under the same constraints derived from the initial clinical plans. The resulting dose distributions were dosimetrically compared in terms of dose volume histograms (DVH) parameters for the planning target volume (PTV) and the organs at risk (OARs), as well as dose difference maps.

Results

In most of the cases helium ion plans provided a similar PTV coverage as protons with a consistent trend of superior OAR sparing. The latter finding was attributed to the ability of helium ions to offer sharper distal and lateral dose fall-offs, as well as a more favorable differential RBE variation in target and normal tissue.

Conclusions

Although more studies are needed to investigate the clinical potential of helium ions for different tumour entities, the results of this work based on an experimentally validated MC engine support the promise of this modality with state-of-the-art pencil beam scanning delivery, especially in case of tumours growing in close proximity of multiple OARs such as meningiomas.

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Haberer T, Debus J, Jäkel O, Schulz-Ertner D, Weber U. The Heidelberg ion therapy center. Radiother Oncol. 2004;73:186–90. https://doi.org/10.1016/S0167-8140(04)80046-X.

Castro JR, Petti PL, Blakely EA, Linstadt DE. Particle radiation therapy. Tech. Rep. LBL−36229. PA: W.B. Saunders Company; 1994.

Kaplan ID, Castro JR, Phillips TL. Helium charged particle radiotherapy for meningioma: experience at UCLBL. Int J Radiat Oncol Biol Phys. 1994;28(1):257–61.CrossRefPubMed

Tessonnier T, Mairani A, Brons S, Haberer T, Debus J, Parodi K. Experimental dosimetric comparison of 1H, 4He, 12C and 16O scanned ion beams. Phys Med Biol. 2017;62(10):3958–82. https://doi.org/10.1088/1361-6560/aa6516.

Tessonnier T, Böhlen TT, Cerutti F, et al. Dosimetric verification in water of a Monte Carlo treatment planning tool for proton, helium, carbon and oxygen ion beams at the Heidelberg ion beam therapy Center. Phys Med Biol. 2017; https://doi.org/10.1088/1361-6560/aa7be4.

Dokic I, Mairani A, Niklas M, et al. Next generation multi-scale biophysical characterization of high precision cancer particle radiotherapy using clinical proton, helium-, carbon- and oxygen ion beams. Oncotarget. 2016;7(35):56676–89. https://doi.org/10.18632/oncotarget.10996.

Vernimmen FJ, Harris JK, Wilson JA, Melvill R, Smit BJ, Slabbert JP. Stereotactic proton beam therapy of skull base meningiomas. Int J Radiat Oncol Biol Phys. 2001;49(1):99–105.CrossRefPubMed

Grün R, Friedrich T, Krämer M, et al. Assessment of potential advantages of relevant ions for particle therapy: a model based study. Med Phys. 2015;42(2):1037–47. https://doi.org/10.1118/1.4905374.

Fuchs H, Alber M, Schreiner T, Georg D. Implementation of spot scanning dose optimization and dose calculation for helium ions in Hyperion. Med Phys. 2015 Sep;42(9):5157–66. https://doi.org/10.1118/1.4927789.

10.

Knäusl B, Fuchs H, Dieckmann K, Georg D. Can particle beam therapy be improved using helium ions? – a planning study focusing on pediatric patients. Acta Oncol. 2016;55(6):751–9. https://doi.org/10.3109/0284186X.2015.1125016.

11.

Tessonnier T, Mairani A, Brons S, et al. Helium ions at the Heidelberg ion beam therapy Center: comparisons between FLUKA Monte Carlo code predictions and dosimetric measurements. Phys Med Biol. 2017;62:6784–803.CrossRefPubMed

12.

Böhlen TT, Bauer J, Dosanjh M, et al. A Monte Carlo-based treatment-planning tool for ion beam therapy. J Radiat Res. 2013;54 Suppl 1:i77–81. https://doi.org/10.1093/jrr/rrt050.

13.

Mairani A, Böhlen T, Schiavi A, et al. A Monte Carlo based-treatment tool for proton therapy. Phys Med Biol. 2013;58(8):2471–90. https://doi.org/10.1088/0031-9155/58/8/2471.

14.

Mairani A, Magro G, Dokic I, et al. Data-driven RBE parameterization for helium ion beams. Phys Med Biol. 2016;61(2):888–905. https://doi.org/10.1088/0031-9155/61/2/888.

15.

Mairani A, Dokic I, Magro G, et al. Biologically optimized helium ion plans: calculation approach and its in vitro validation. Phys Med Biol. 2016;61(11):4283–99. https://doi.org/10.1088/0031-9155/61/11/4283.

16.

Mairani A, Dokic I, Magro G, et al. A phenomenological relative biological effectiveness approach for proton therapy based on an improved description of the mixed radiation field. Phys Med Biol. 2017;62(4):1378–95. https://doi.org/10.1088/1361-6560/aa51f7.

17.

Paganetti H, Niemierko A, Ancukiewicz M, et al. Relative biological effectiveness (RBE) values for proton beam therapy. Int J Radiat Oncol Biol Phys. 2002;53(2):407–21.CrossRefPubMed

18.

Carabe A, Moteabbed M, Depauw N, Schuemann J, Paganetti H. Range uncertainty in proton therapy due to variable biological effectiveness. Phys Med Biol. 2012;57(5):1159–72.CrossRefPubMed

19.

Wedenberg M, Lind BK, Hardemark B. A model for the relative biological effectiveness of protons: the tissue specific parameter α/β of photons is a predictor for the sensitivity to LET changes. Acta Oncol. 2013;52(3):580–8. https://doi.org/10.3109/0284186X.2012.705892.

20.

Fowler JF. The linear-quadratic formula and progress in fractionated radiotherapy. Br J Radiol. 1989;62(740):679–94.

21.

Santacroce A, Kamp MA, Budach W, Häanggi D. Radiobiology of Radiosurgery for the central nervous system. Biomed Res Int. 2013;2013:362761. https://doi.org/10.1155/2013/362761.

22.

Vernimmen FJ, Slabbert JP. Assessment of the α/ß ratios for arteriovenous malformations, meningiomas, acoustic neuromas, and the optic chiasma. Int J Radiat Biol. 2010;86(6):486–98. https://doi.org/10.3109/09553001003667982.

23.

Battistoni G, Bauer J, Böhlen TT, et al. The FLUKA code: an accurate simulation tool for particle therapy. Front Oncol. 2016;6:116. https://doi.org/10.3389/fonc.2016.00116.

24.

Böhlen TT, Cerutti F, Chin MPW, et al. The FLUKA code: developments and challenges for high energy and medical applications. Nuclear data sheets. 2014;120 https://doi.org/10.1016/j.nds.2014.07.049.

25.

Ferrari A, Sala PR, Fassò A,Ranft J. FLUKA: a multi-particle transport code, CERN-2005-10 (2005), INFN/TC_05/11, SLAC-R-773.

26.

Weber U, Kraft G. Design and construction of a ripple filter for a smoothed depth dose distribution in conformal particle therapy. Phys Med Biol. 1999;44 https://doi.org/10.1088/0031-9155/44/11/306.

27.

Paganetti H, Jiang H, Parodi K, Slopsema R, Engelsman M. Clinical implementation of full Monte Carlo dose calculation in proton beam therapy. Phys Med Biol. 2008;53(17):4825–53. https://doi.org/10.1088/0031-9155/53/17/023.

28.

Bauer J, Sommerer F, Mairani A, Unholtz D, Farook R, Handrack J, Tessonnier T, et al. 2014. Integration and evaluation of automated Monte Carlo simulations in the clinical practice of scanned proton and carbon ion beam therapy. Phys Med Biol. 2014;59(16):4635–59. https://doi.org/10.1088/0031-9155/59/16/4635.

29.

Tessonnier T, Marcelos T, Mairani A, Brons S, Parodi K. Phase space generation for proton and carbon ion beams for external users’ applications at the Heidelberg ion therapy Center. Front Oncol. 2016;5:297. https://doi.org/10.3389/fonc.2015.00297.

30.

Magro G, Molinelli S, Mairani A, et al. Dosimetric accuracy of a treatment planning system for actively scanned proton beams and small target volumes: Monte Carlo and experimental validation. Phys Med Biol. 2015;60(17):6865–80. https://doi.org/10.1088/0031-9155/60/17/6865.

31.

Giovannini G, Böhlen TT, Cabal G, et al. Variable RBE in proton therapy: comparison of model predictions and their influence on clinical-like scenarios. Radiat Oncol. 2016;11:68. https://doi.org/10.1186/s13014-016-0642-6.

32.

Tessonnier T. Treatment of low-grade meningiomas with protons and helium ions. PhD dissertation LMU Munich. 2017; https://edoc.ub.uni-muenchen.de/20602/7/Tessonnier_Thomas.pdf.

33.

Frey K, Unholtz D, Bauer J, et al. Automation and uncertainty analysis of a method for in-vivo range verification in particle therapy. Phys Med Biol. 2014;59(19):5903–19. https://doi.org/10.1088/0031-9155/59/19/5903.

34.

Handrack J, Tessonnier T, Chen W et al. Sensitivity of post treatment positron-emission-tomography/computed-tomography to detect inter-fractional range variations in scanned ion beam therapy. Acta Oncol. 2017 (accepted).

35.

Xie Y, Bentefour H, Janssens G, et al. Prompt gamma imaging for in vivo range verification of pencil beam scanning proton therapy. Int J Radiat Oncol Biol Phys. https://doi.org/10.1016/j.ijrobp.2017.04.027.

Title: Proton and helium ion radiotherapy for meningioma tumors: a Monte Carlo-based treatment planning comparison
Authors: Thomas Tessonnier
Andrea Mairani
Wenjing Chen
Paola Sala
Francesco Cerutti
Alfredo Ferrari
Thomas Haberer
Jürgen Debus
Katia Parodi
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2018
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-017-0944-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Proton and helium ion radiotherapy for meningioma tumors: a Monte Carlo-based treatment planning comparison

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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