The Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy

Purpose: Variable relative biological effectiveness (RBE) models allow for differences in linear energy transfer (LET), physical dose, and tissue type to be accounted for when quantifying and optimizing the biological damage of protons. These models are complex and fraught with uncertainties, and th...

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Autores principales:	Helge Henjum, MSc, Tordis J. Dahle, PhD, Lars Fredrik Fjæra, MSc, Eivind Rørvik, MSc, Sara Pilskog, PhD, Camilla H. Stokkevåg, PhD, Andrea Mairani, PhD, Kristian S. Ytre-Hauge, PhD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/237f6ab9f54e4badaf8f91c84ece78a7
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spelling	oai:doaj.org-article:237f6ab9f54e4badaf8f91c84ece78a72021-11-04T04:34:37ZThe Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy2452-109410.1016/j.adro.2021.100776https://doaj.org/article/237f6ab9f54e4badaf8f91c84ece78a72021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2452109421001342https://doaj.org/toc/2452-1094Purpose: Variable relative biological effectiveness (RBE) models allow for differences in linear energy transfer (LET), physical dose, and tissue type to be accounted for when quantifying and optimizing the biological damage of protons. These models are complex and fraught with uncertainties, and therefore, simpler RBE optimization strategies have also been suggested. Our aim was to compare several biological optimization strategies for proton therapy by evaluating their performance in different clinical cases. Methods and Materials: Two different optimization strategies were compared: full variable RBE optimization and differential RBE optimization, which involve applying fixed RBE for the planning target volume (PTV) and variable RBE in organs at risk (OARs). The optimization strategies were coupled to 2 variable RBE models and 1 LET-weighted dose model, with performance demonstrated on 3 different clinical cases: brain, head and neck, and prostate tumors. Results: In cases with low (α/β)x in the tumor, the full RBE optimization strategies had a large effect, with up to 10% reduction in RBE-weighted dose to the PTV and OARs compared with the reference plan, whereas smaller variations (<5%) were obtained with differential optimization. For tumors with high (α/β)x, the differential RBE optimization strategy showed a greater reduction in RBE-weighted dose to the OARs compared with the reference plan and the full RBE optimization strategy. Conclusions: Differences between the optimization strategies varied across the studied cases, influenced by both biological and physical parameters. Whereas full RBE optimization showed greater OAR sparing, awareness of underdosage to the target must be carefully considered.Helge Henjum, MScTordis J. Dahle, PhDLars Fredrik Fjæra, MScEivind Rørvik, MScSara Pilskog, PhDCamilla H. Stokkevåg, PhDAndrea Mairani, PhDKristian S. Ytre-Hauge, PhDElsevierarticleMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENAdvances in Radiation Oncology, Vol 6, Iss 6, Pp 100776- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Helge Henjum, MSc Tordis J. Dahle, PhD Lars Fredrik Fjæra, MSc Eivind Rørvik, MSc Sara Pilskog, PhD Camilla H. Stokkevåg, PhD Andrea Mairani, PhD Kristian S. Ytre-Hauge, PhD The Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy
description	Purpose: Variable relative biological effectiveness (RBE) models allow for differences in linear energy transfer (LET), physical dose, and tissue type to be accounted for when quantifying and optimizing the biological damage of protons. These models are complex and fraught with uncertainties, and therefore, simpler RBE optimization strategies have also been suggested. Our aim was to compare several biological optimization strategies for proton therapy by evaluating their performance in different clinical cases. Methods and Materials: Two different optimization strategies were compared: full variable RBE optimization and differential RBE optimization, which involve applying fixed RBE for the planning target volume (PTV) and variable RBE in organs at risk (OARs). The optimization strategies were coupled to 2 variable RBE models and 1 LET-weighted dose model, with performance demonstrated on 3 different clinical cases: brain, head and neck, and prostate tumors. Results: In cases with low (α/β)x in the tumor, the full RBE optimization strategies had a large effect, with up to 10% reduction in RBE-weighted dose to the PTV and OARs compared with the reference plan, whereas smaller variations (<5%) were obtained with differential optimization. For tumors with high (α/β)x, the differential RBE optimization strategy showed a greater reduction in RBE-weighted dose to the OARs compared with the reference plan and the full RBE optimization strategy. Conclusions: Differences between the optimization strategies varied across the studied cases, influenced by both biological and physical parameters. Whereas full RBE optimization showed greater OAR sparing, awareness of underdosage to the target must be carefully considered.
format	article
author	Helge Henjum, MSc Tordis J. Dahle, PhD Lars Fredrik Fjæra, MSc Eivind Rørvik, MSc Sara Pilskog, PhD Camilla H. Stokkevåg, PhD Andrea Mairani, PhD Kristian S. Ytre-Hauge, PhD
author_facet	Helge Henjum, MSc Tordis J. Dahle, PhD Lars Fredrik Fjæra, MSc Eivind Rørvik, MSc Sara Pilskog, PhD Camilla H. Stokkevåg, PhD Andrea Mairani, PhD Kristian S. Ytre-Hauge, PhD
author_sort	Helge Henjum, MSc
title	The Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy
title_short	The Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy
title_full	The Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy
title_fullStr	The Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy
title_full_unstemmed	The Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy
title_sort	organ sparing potential of different biological optimization strategies in proton therapy
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/237f6ab9f54e4badaf8f91c84ece78a7
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The Organ Sparing Potential of Different Biological Optimization Strategies in Proton Therapy

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