Gantry-based pencil beam scanning proton therapy for uveal melanoma: IMPT versus proton arc therapy

被引：0

作者：

Qi, Hang ^{[1
]}

Hu, Lei ^{[2
]}

Huang, Sheng ^{[3
]}

Lee, Yen-Po ^{[4
]}

Yu, Francis ^{[1
]}

Chen, Qing ^{[1
]}

Yang, Yunjie ^{[5
]}

Kang, Minglei ^{[1
]}

Zhai, Huifang ^{[1
]}

Vermeulen, Milo ^{[1
]}

Shim, Andy ^{[1
]}

Park, Peter ^{[1
]}

Ding, Xuanfeng ^{[6
]}

Zhou, Jun ^{[7
]}

Abramson, David H. ^{[5
]}

Francis, Jasmine H. ^{[5
]}

Simone, Charles B. ^{[1
,5
]}

Barker, Christopher A. ^{[1
,5
]}

Lin, Haibo ^{[1
,5
,8
]}

机构：

[1] New York Proton Ctr, New York, NY 10035 USA

[2] Inova Schar Canc Inst, Fairfax, VA USA

[3] Tianjin Med Univ Canc Inst & Hosp, Tianjin, Peoples R China

[4] Univ Iowa Hlth Care, Iowa City, IA USA

[5] Mem Sloan Kettering Canc Ctr, New York, NY 10029 USA

[6] William Beaumont Univ Hosp, Corewell Hlth, Royal Oak, MI USA

[7] Emory Univ, Atlanta, GA USA

[8] Albert Einstein Coll Med, Montefiore Med Ctr, Dept Radiat Oncol, Bronx, NY 10471 USA

来源：

RADIATION ONCOLOGY | 2025年 / 20卷 / 01期

关键词：

Uveal melanoma; Pencil beam scanning; Intensity modulated proton therapy; Proton arc therapy; RADIATION-THERAPY; DOSIMETRIC ACCURACY; DELIVERY-EFFICIENT; SPARC THERAPY; RADIOTHERAPY; IRRADIATION; OUTCOMES; CANCER; ROBUST;

D O I：

10.1186/s13014-025-02621-y

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background This study reports the single-institution clinical experience of multifield pencil beam scanning (PBS) intensity-modulated proton therapy (IMPT) and dosimetric comparison to proton arc for uveal melanoma (UM) in a regular PBS gantry room. Methods Eleven consecutive UM patients were treated with IMPT to 50 Gy in 5 fractions. A customized gaze-fixation device attached to the thermoplastic mask was used to reproduce the globe position for each patient. IMPT plans were robustly optimized with perturbations of 3 mm setup and 3.5% range uncertainties using 3-4 fields without apertures. Each plan was robustly reoptimized (using the same perturbation parameters) using two non-coplanar arc fields in the RayStation treatment planning system. Treatment quality for both plans was evaluated daily using CBCT-generated synthetic CT. Target coverage, conformity, and mean/maximum doses to adjacent organs were assessed. Results Proton arc plans provided comparable plan quality compared to IMPT plans. Similar target coverage was achieved, with an average GTV D95% equal to 101.1% +/- 1.0% and 101.4% +/- 0.4% for IMPT and proton arc plans, respectively. Proton arc improves the conformity index (RTOG) compared to IMPT plans (average 0.96 +/- 0.23 vs. 0.88 +/- 0.18, p = 0.11). Both modalities met all the clinical goals for organs-at-risk (OARs), while proton arc significantly reduced the maximum dose for the retina from, on average, 54.5 +/- 0.7 to 53.2 +/- 0.3 Gy (p < 0.01). Treatment evaluation on synthetic CT showed that the doses received by patients were highly consistent with the planned doses, with a relative target coverage (D95%) difference within 3.5% for IMPT and 3.1% for proton arc, and the D95% of actual delivery exceeding 98.7% and 98.2%, respectively. The doses delivered to OARs did not exceed clinical constraints. Conclusions This is a novel report on proton arc for ocular tumors and gantry-based multifield PBS proton treatment for these tumors. This study demonstrated that both modalities can meet the clinical goals. The IMPT is currently clinically implanted, and 2-field non-coplanar proton arc plans can achieve comparable dosimetric metrics to those of IMPT plans when the deliver technique is matured.

引用

页数：11

共 54 条

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