Abstract
The purpose of this study has been to compare photon intensity modulated radiation
therapy (IMRT) against both conformal and intensity modulated proton therapy (IMPT)
plans for metastatic brain cancer. Ten IMRT patients with brain cancer were chosen
retrospectively, with prescription doses in the range of 20 to 40 Gy, delivered in
3 to 5 fractions using Varian TrueBeam STx machine. Three proton plans with proton
double scattering, single collimation static-IMPT, and energy layer by layer collimation
dynamic-IMPT were then generated for the same patients using the Mevion S250 system
for conformal plans and the S250i system for IMPT plans. Each plan had respective
treatment planning systems that include Brainlab iPlan for IMRT, Varian Eclipse for
proton double scattering, and RaySearch Raystation for IMPT. Dosimetric and radiobiologic
comparisons were made through dose-volume histogram (DVH) analysis of the target and
the organs at risk (OAR); and with parameters of equivalent uniform dose (EUD), tumor
control probability (TCP), and normal tissue complication probability (NTCP), respectively.
A set of variables α/β ratio, survival fraction, and clonogenic cell density were
selected and varied to observe their effect on the abovementioned parameters. Doses
were observed to be more homogeneous for patients with brain malignancies with photon
IMRT treatments, while dose conformity is improved with proton PBS treatments. Normal
tissue is, on average, spared more through both proton treatment options. The minimum
doses, closely approximated by dose to 98% of the target volume, are similar across
treatment modalities with slight variations.
Keywords
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Article info
Publication history
Published online: January 22, 2023
Accepted:
January 4,
2023
Received:
November 7,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
