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Open Access 01-12-2022 | Research

Quantification of biological range uncertainties in patients treated at the Krakow proton therapy centre

Authors: Magdalena Garbacz, Jan Gajewski, Marco Durante, Kamil Kisielewicz, Nils Krah, Renata Kopeć, Paweł Olko, Vincenzo Patera, Ilaria Rinaldi, Marzena Rydygier, Angelo Schiavi, Emanuele Scifoni, Tomasz Skóra, Agata Skrzypek, Francesco Tommasino, Antoni Rucinski

Published in: Radiation Oncology | Issue 1/2022

Abstract

Background

Variable relative biological effectiveness (vRBE) in proton therapy might significantly modify the prediction of RBE-weighted dose delivered to a patient during proton therapy. In this study we will present a method to quantify the biological range extension of the proton beam, which results from the application of vRBE approach in RBE-weighted dose calculation.

Methods and materials

The treatment plans of 95 patients (brain and skull base patients) were used for RBE-weighted dose calculation with constant and the McNamara RBE model. For this purpose the Monte Carlo tool FRED was used. The RBE-weighted dose distributions were analysed using indices from dose-volume histograms. We used the volumes receiving at least 95% of the prescribed dose (V95) to estimate the biological range extension resulting from vRBE approach.

Results

The vRBE model shows higher median value of relative deposited dose and D95 in the planning target volume by around 1% for brain patients and 4% for skull base patients. The maximum doses in organs at risk calculated with vRBE was up to 14 Gy above dose limit. The mean biological range extension was greater than 0.4 cm.

Discussion

Our method of estimation of biological range extension is insensitive for dose inhomogeneities and can be easily used for different proton plans with intensity-modulated proton therapy (IMPT) optimization. Using volumes instead of dose profiles, which is the common method, is more universal. However it was tested only for IMPT plans on fields arranged around the tumor area.

Conclusions

Adopting a vRBE model results in an increase in dose and an extension of the beam range, which is especially disadvantageous in cancers close to organs at risk. Our results support the need to re-optimization of proton treatment plans when considering vRBE.

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Title: Quantification of biological range uncertainties in patients treated at the Krakow proton therapy centre
Authors: Magdalena Garbacz
Jan Gajewski
Marco Durante
Kamil Kisielewicz
Nils Krah
Renata Kopeć
Paweł Olko
Vincenzo Patera
Ilaria Rinaldi
Marzena Rydygier
Angelo Schiavi
Emanuele Scifoni
Tomasz Skóra
Agata Skrzypek
Francesco Tommasino
Antoni Rucinski
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2022
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-022-02022-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantification of biological range uncertainties in patients treated at the Krakow proton therapy centre

Abstract

Background

Methods and materials

Results

Discussion

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods and materials

Results

Discussion

Conclusions

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