Sensitivity of intensity modulated proton therapy plans to changes in patient weight

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Francesca AlbertiniGudrun Goitein

Abstract

A retrospective study to investigate the sensitivity of intensity modulated proton therapy (IMPT) to changes in body weight occurring during the course of radiotherapy for patients treated in the sacral region. During therapy, important weight gain and loss were observed for two patients treated to para-spinal tumors, which resulted in both patients being re-scanned and re-planned. Both patients were treated as part of their therapy, with a narrow-angle IMPT (NA-IMPT) plan delivering a 'dose hole' around the cauda equina (CE), which was mainly formed through modulation of Bragg peaks in depth. To investigate the impact of these weight changes on the proton range and delivered dose, the nominal fields were re-calculated on the new CT data sets. Results were analyzed by comparing these new plans with those originally delivered and by calculating changes in range and delivered doses in target volumes and normal tissues. Maximum differences in proton range in the CE region of up to +8 mm and -13 mm, respectively, for the patient who gained weight and for the patient who lost weight, increased the maximum dose to the CE by only 2%. This indicates that both IMPT plans were relatively insensitive to substantial range uncertainties. Ev...Continue Reading

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Apr 13, 2010·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Dag Rune Olsen, Jens Overgaard
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