论文标题
铅笔梁扫描的更大功能是否减少了对质子龙门的需求?头颈和脑肿瘤的研究
Does the greater power of pencil beam scanning reduce the need for a proton gantry? A study of head-and-neck and brain tumors
论文作者
论文摘要
没有龙门果的质子治疗系统在资本成本方面可能更紧凑,更便宜,因此更大的患者人群可用。铅笔梁扫描和机器人技术的进步会导致无龙杆菌的治疗吗?在这项研究中,我们探讨了是否可以在没有龙门的情况下获得高质量的治疗计划。 我们最近表明,使用新的软机器人固定装置和成像,与患者处于直立位置的质子治疗可能是可行的,这在治疗过程中可以多种可能的患者取向。在这项研究中,我们评估了这种新的治疗几何形状是否可以实现无龙门的高质量治疗计划。我们为七名头颈或脑肿瘤患者创建了铅笔梁扫描(PBS)治疗计划。每位患者都计划有两种情况:一个患者仰卧,一个龙门,另一个患者固定的水平梁线,患者坐着直立。对于治疗计划,报道了剂量 - 体积 - 历史图(DVHS),目标均匀性指数(HI),平均剂量,D_2和D_98。使用+/- 2.5 mm的设置错误和+/- 3.5%的范围不确定性对一个计划进行了鲁棒性分析,并进行了九种情况。 与PBS-GARTRY计划相比,大多数PBS-GARTRY计划的目标HI和OAR平均剂量与范围不确定性和设置错误相似。 铅笔梁扫描提供了足够的功率来提供高质量的治疗计划,而无需龙头颈部或脑部肿瘤。结合支持这种治疗几何形状所需的新定位和固定方法的发展,这项工作表明,具有固定的水平光束线进一步开发紧凑型质子治疗系统,以治疗坐姿和斜切位置的患者。
Proton therapy systems without a gantry can be more compact and less expensive in terms of capital cost, and therefore more available to a larger patient population. Would the advances in pencil beam scanning and robotics make gantry-less treatment possible? In this study, we explore if high-quality treatment plans can be obtained without a gantry. We recently showed that proton treatments with the patient in an upright position may be feasible with a new soft robotic immobilization device and imaging which enables multiple possible patient orientations during a treatment. In this study, we evaluate if this new treatment geometry could enable high quality treatment plans without a gantry. We created pencil beam scanning (PBS) treatment plans for seven patients with head-and-neck or brain tumors. Each patient was planned with two scenarios: one with a gantry with the patient in supine position and the other with a gantry-less fixed horizontal beam-line with the patient sitting upright. For the treatment plans, dose-volume-histograms (DVHs), target homogeneity index (HI), mean dose, D_2 and D_98 are reported. A robustness analysis of one plan was performed with +/-2.5 mm setup errors and +/-3.5% range uncertainties with nine scenarios. Most of the PBS-gantry-less plans had similar target HI and OAR mean dose as compared to PBS-gantry plans, and similar robustness with respect to range uncertainties and setup errors. Pencil beam scanning provides sufficient power to deliver high quality treatment plans without requiring a gantry for head-and-neck or brain tumors. In combination with the development of the new positioning and immobilization methods required to support this treatment geometry, this work suggests the feasibility of further development of a compact proton therapy system with a fixed horizontal beam-line to treat patients in sitting and reclined positions.