4/14/2023 0 Comments Carl rossi proton email![]() ![]() For the lung cases, mean ± SD differences in MLD, MHD, and D 1(spine) between IMPT_3D and IMPT_4D were 0.34 ± 0.37 Gy RBE, 0.39 ± 0.53 Gy RBE, and 1.68 ± 4.19 Gy RBE, respectively. Concerning OARs, there was no pronounced dosimetric benefit of IMPT_4D over IMPT_3D. ![]() Relative to the planned dose differences between VMAT and IMPT_3D, the differences between IMPT_3D and IMPT_4D remained almost indiscernible. Maximum differences between VMAT and IMPT_3D reached up to 3.52 Gy RBE (MLD), 20.58 Gy RBE (MHD), and 30.70 Gy RBE (D 1(spine)) for the lung, and 5.09 Gy RBE (MLD), 13.55 Gy RBE (MHD), and 5.20 Gy RBE (D 1(spine)) for the oesophageal cancer patients. For the oesophageal cancer patients, these differences were 3.76 ± 0.92 Gy RBE, 9.51 ± 2.25 Gy RBE, and −0.51 ± 4.85 Gy RBE for MLD, MHD, and D 1(spine), respectively. For the lung cancer patients, mean ± SD differences in MLD, MHD, and D 1(spine) between VMAT and IMPT_3D were 2.75 ± 0.56 Gy RBE, 5.38 ± 7.36 Gy RBE, and 17.71 ± 8.59 Gy RBE, respectively. Five times layered rescanning was used as motion mitigation technique [įor all patients, the OAR DVH parameters obtained with VMAT, IMPT_3D, and IMPT_4D were computed ( Fig. The spot sizes at our beam line range from 6.5 mm to 3.0 mm for proton energies from 70 MeV to 230 MeV in air (sigma at isocentre). 5.2), and after final clinical acceptance, the plans were delivered in dry runs at our proton facility to obtain log files. If all robustness criteria were met ( Suppl. The robustness of the plans was then evaluated in voxel-wise worst-case minimum (Vw min) and voxel-wise worst-case maximum (Vw max) dose distributions, which score the minimum and maximum dose per voxel over all calculated scenarios, respectively. Range errors were considered by applying density perturbations of ± 3%. Setup errors were modelled by shifting the planning isocentre in fixed translations in fourteen directions (with magnitudes of 6.0 mm and 8.0 mm for lung and oesophagus indications, respectively). This 3D robustness evaluation method (3DREM), which is part of our clinical protocol for proton treatment planning, accounts for several disturbing scenarios, simulating different patient setup and range errors.
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