Investigate Potential Clinical Benefits and Linear Energy Transfer Sparing Utilizing Proton Arc Therapy for Hepatocellular Carcinoma Cancer
Document Type
Conference Proceeding
Publication Date
3-2024
Publication Title
International Journal of Particle Therapy
Abstract
Purpose: To investigate the potential clinical benefits and doseaveraged Linear Energy Transfer (LETd) sparing, utilizing proton arc plan for Hepatocellular carcinoma (HCC) patients in comparison with Intensity Modulated Proton Therapy (IMPT). Methods: Five HCC patients have been retrospectively selected. Two planning groups were created: Proton Arc plans using Monaco ver. 6 and the clinical IMPT plan. Both planning groups used the same robustness parameters. The prescription dose is 67.5 Gy (RBE) in 15 fractions of the Clinical Target Volume (CTV). Robustness evaluations were performed to ensure dose coverage. Normal Tissue Complicated Probability (NTCP) model was utilized to predict the possibility of Radiation-Induced Liver Disease (RILD) and evaluate the potential benefit of proton arc therapy. LETd calculation and evaluation were performed as well. Results: Proton arc plan has shown better dosimetric improvements of most Organ-At-Risks (OARs) (Table1). More specifically, the liver mean dose has been significantly reduced from 11.27 GyE to 8.7 GyE compared to the IMPT plan. The predicted possibility of RILD has also been significantly reduced for cases with a large and deep liver target where healthy liver tissue sparing is a challenge (Figure 1). Additionally, proton arc therapy could increase the average LETd in the CTV and reduce LETd in adjacent OARs (Figure 2). Conclusions: Proton arc could effectively mitigate the possibility of RILD by reducing liver mean dose. Compared to IMPT, proton arc can reduce LETd to OARs and increase the LETd on targets, potentially mitigating the radiation-induced side effects and improving the tumor control probability further.
Volume
11
Issue
Suppl
First Page
9
Recommended Citation
Liu P, Dalfsen R, Soukup M, Dolan J, Chen S, Zhao L, et al. [Stevens C, Deroniyagala R, Li X, Ding X]. Investigate potential clinical benefits and linear energy transfer sparing utilization proton arc therapy for hepatocellular carcinoma cancer. Int J Part Ther. 2024 Mar;11(Suppl):9. doi:10.1016/j.ijpt.2024.100044
DOI
10.1016/j.ijpt.2024.100044
Comments
9th Annual Conference of the Particle Therapy Cooperative Group North American (PTCOG-NA), October 28-30, 2023, Seattle, WA