Proton therapy of lung cancer patients - Treatment strategies and clinical experience from a medical physicist's perspective

被引：1

作者：

Taasti, Vicki Trier ^{[1
]}

Kneepkens, Esther ^{[1
]}

van der Stoep, Judith ^{[1
]}

Velders, Marije ^{[1
]}

Cobben, Maud ^{[1
]}

Vullings, Anouk ^{[1
]}

Buck, Janou ^{[1
]}

Visser, Femke ^{[1
]}

van den Bosch, Maud ^{[1
]}

Hattu, Djoya ^{[1
]}

Mannens, Jolein ^{[1
]}

in 't Ven, Lieke ^{[1
]}

de Ruysscher, Dirk ^{[1
]}

van Loon, Judith ^{[1
]}

Peeters, Stephanie ^{[1
]}

Unipan, Mirko ^{[1
]}

Rinaldi, Ilaria ^{[1
]}

机构：

[1] Maastricht Univ Med Ctr, GROW Sch Oncol & Reprod, Dept Radiat Oncol Maastro, Maastricht, Netherlands

来源：

PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS | 2025年 / 130卷

关键词：

Lung cancer; Proton therapy; Clinical experience; Treatment strategies; Moving tumours; BREATH-HOLD; RADIOTHERAPY; MOTION; REDUCTION; INTERPLAY; SELECTION; SYSTEM; TUMOR; MODEL; STAGE;

D O I：

10.1016/j.ejmp.2024.104890

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: Proton therapy of moving targets is considered a challenge. At Maastro, we started treating lung cancer patients with proton therapy in October 2019. In this work, we summarise the developed treatment strategies and gained clinical experience from a physics point of view. Methods: We report on our clinical approaches to treat lung cancer patients with the Mevion Hyperscan S250i proton machine. We classify lung cancer patients as small movers (tumour movement <= 5 mm) or large movers (tumour movement > 5 mm). The preferred beam configuration has evolved over the years of clinical treatment, and currently mostly two or three beam directions are used. All patients are treated with robustly optimised plans (5 mm setup and 3% range uncertainty). Small movers are planned based on a clinical target volume (CTV) with a 3 mm isotropic margin expansion to account for motion, while large movers are planned based on an internal target volume (ITV). All patients are treated in free-breathing. Results: Between October 2019 and December 2023, 379 lung cancer patients have been treated, of which 130 were large movers. The adaptation rate was 28%. The median treatment time has been reduced from 30 to 23 min. The mean dose to the heart, oesophagus, and lungs was on average 4.3, 15.4, and 11.0 Gy, respectively. Conclusions: Several treatment planning and workflow improvements have been introduced over the years, resulting in an increase of treatment quality and number of treated patients, as well as reduction of planning and treatment time.

引用

页数：13

共 59 条

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