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Comparison of intensity modulated x-ray therapy and intensity modulated proton therapy for selective subvolume boosting: a phantom study
Journal article   Peer reviewed

Comparison of intensity modulated x-ray therapy and intensity modulated proton therapy for selective subvolume boosting: a phantom study

R T Flynn, D L Barbee, T R Mackie and R Jeraj
Physics in medicine & biology, Vol.52(20), pp.6073-6091
10/21/2007
DOI: 10.1088/0031-9155/52/20/001
PMCID: PMC2712448
PMID: 17921573

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Abstract

Selective subvolume boosting can theoretically improve tumour control probability while maintaining normal tissue complication probabilities similar to those of uniform dose distributions. In this work the abilities of intensity modulated x-ray therapy (IMXT) and intensity modulated proton therapy (IMPT) to deliver boosts to multiple subvolumes of varying size and proximities are compared in a thorough phantom study. IMXT plans were created using the step-and-shoot (IMXT-SAS) and helical tomotherapy (IMXT-HT) methods. IMPT plans were created with the spot scanning (IMPT-SS) and distal gradient tracking (IMPT-DGT) methods. IMPT-DGT is a generalization of the distal edge tracking method designed to reduce the number of proton beam spots required to deliver non-uniform dose distributions relative to IMPT-SS. The IMPT methods were delivered over both 180° and 360° arcs. The IMXT-SAS and IMPT-SS methods least and most optimally satisfied the non-uniform dose prescriptions, respectively. The IMPT delivery methods reduced normal tissue integral dose by a factor of about two relative to the IMXT delivery methods, regardless of the delivery arc. The IMPT-DGT method reduced the number of proton beam spots by a factor of about three relative to the IMPT-SS method.
distal gradient tracking intensity modulated x-ray therapy Intensity modulated radiation therapy selective subvolume boosting intensity modulated proton therapy

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