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Technical Note: A treatment plan comparison between dynamic collimation and a fixed aperture during spot scanning proton therapy for brain treatment
Journal article   Open access   Peer reviewed

Technical Note: A treatment plan comparison between dynamic collimation and a fixed aperture during spot scanning proton therapy for brain treatment

Blake Smith, Edgar Gelover, Alexandra Moignier, Dongxu Wang, Ryan T Flynn, Liyong Lin, Maura Kirk, Tim Solberg and Daniel E Hyer
Medical physics (Lancaster), Vol.43(8), pp.4693-4699
08/2016
DOI: 10.1118/1.4955117
PMCID: PMC5360163
PMID: 27487886
url
https://doi.org/10.1118/1.4955117View
Published (Version of record) Open Access

Abstract

To quantitatively assess the advantages of energy-layer specific dynamic collimation system (DCS) versus a per-field fixed aperture for spot scanning proton therapy (SSPT). Five brain cancer patients previously planned and treated with SSPT were replanned using an in-house treatment planning system capable of modeling collimated and uncollimated proton beamlets. The uncollimated plans, which served as a baseline for comparison, reproduced the target coverage and organ-at-risk sparing of the clinically delivered plans. The collimator opening for the fixed aperture-based plans was determined from the combined cross sections of the target in the beam's eye view over all energy layers which included an additional margin equivalent to the maximum beamlet displacement for the respective energy of that energy layer. The DCS-based plans were created by selecting appropriate collimator positions for each row of beam spots during a Raster-style scanning pattern which were optimized to maximize the dose contributions to the target and limited the dose delivered to adjacent normal tissue. The reduction of mean dose to normal tissue adjacent to the target, as defined by a 10 mm ring surrounding the target, averaged 13.65% (range: 11.8%-16.9%) and 5.18% (2.9%-7.1%) for the DCS and fixed aperture plans, respectively. The conformity index, as defined by the ratio of the volume of the 50% isodose line to the target volume, yielded an average improvement of 21.35% (19.4%-22.6%) and 8.38% (4.7%-12.0%) for the DCS and fixed aperture plans, respectively. The ability of the DCS to provide collimation to each energy layer yielded better conformity in comparison to fixed aperture plans.
Proton Therapy Brain Neoplasms - radiotherapy Radiotherapy Planning, Computer-Assisted - methods Humans

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