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Is it beneficial to use apertures in proton radiosurgery with a scanning beam? A dosimetric comparison in neurinoma and meningioma patients

Righetto, Roberto ; Fellin, Francesco ; Scartoni, Daniele ; Amichetti, Maurizio ; Schwarz, Marco ; Amelio, Dante ; Farace, Paolo

Journal of Applied Clinical Medical Physics, 2022-02, Vol.23 (2), p.e13459-n/a [Periódico revisado por pares]

United States: John Wiley & Sons, Inc

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Título:
Is it beneficial to use apertures in proton radiosurgery with a scanning beam? A dosimetric comparison in neurinoma and meningioma patients
Autor: Righetto, Roberto ; Fellin, Francesco ; Scartoni, Daniele ; Amichetti, Maurizio ; Schwarz, Marco ; Amelio, Dante ; Farace, Paolo
Assuntos: apertures ; Brain cancer ; Humans ; Laboratories ; Medical research ; Medicine, Experimental ; Meningeal Neoplasms - diagnostic imaging ; Meningeal Neoplasms - radiotherapy ; Meningeal Neoplasms - surgery ; Meningioma ; Meningioma - diagnostic imaging ; Meningioma - radiotherapy ; Meningioma - surgery ; Neurilemmoma ; Optimization ; Organs at Risk ; Patients ; pencil beam scanning ; Planning ; Proton Therapy ; Protons ; Radiosurgery ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated ; robustness ; Surgery ; Technical Note ; Technical Notes
É parte de: Journal of Applied Clinical Medical Physics, 2022-02, Vol.23 (2), p.e13459-n/a
Notas: All authors discussed the results and contributed to the final manuscript.
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Descrição: Purpose To assess the dosimetric advantages of apertures in intracranial single fraction proton radiosurgery. Materials and methods Six neuroma and 10 meningioma patients were investigated. For each patient, six plans were computed, with two spot spacing and three aperture settings (no apertures, 5 and 8 mm margin between aperture and clinical target volume [CTV]). All plans were optimized on the CTV with the same beam arrangement and the same single‐field robust optimization (2 mm setup errors, 3.5% range uncertainties). Robustness analysis was performed with 0.5 and 1.0 mm systematic setup errors and 3.5% range uncertainties. CTV coverage in the perturbed scenarios and healthy brain tissue sparing in the surrounding of the CTV were compared. Results Meningiomas were larger and at a shallow depth than neuromas. In neuromas, spot spacing did not affect OAR doses or the robustness of CTV coverage and the apertures reduced brain dose without any significant impact on CTV robustness. In meningiomas, smaller spot spacing produced a reduction in brain V5Gy and improved robustness of CTV coverage; in addition, an 8 mm margin aperture reduced low and medium brain tissue doses without affecting robustness in the 0.5 mm perturbed scenario. A 5 mm margin aperture caused a reduction of plan robustness. Conclusion The optimal use of apertures is a trade‐off between sparing of low and medium dose to the healthy brain and robustness of target coverage, also depending on size and depth of the lesion.
Editor: United States: John Wiley & Sons, Inc
Idioma: Inglês

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Is it beneficial to use apertures in proton radiosurgery with a scanning beam? A dosimetric comparison in neurinoma and meningioma patients

Righetto, Roberto ; Fellin, Francesco ; Scartoni, Daniele ; Amichetti, Maurizio ; Schwarz, Marco ; Amelio, Dante ; Farace, Paolo

United States: John Wiley & Sons, Inc

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