Assessing the robustness of passive scattering proton therapy with regard to local recurrence in stage III non-small cell lung cancer: a secondary analysis of a phase II trial.
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| Abstract | BACKGROUND: We assessed the robustness of passive scattering proton therapy (PSPT) plans for patients in a phase II trial of PSPT for stage III non-small cell lung cancer (NSCLC) by using the worst-case scenario method, and compared the worst-case dose distributions with the appearance of locally recurrent lesions. METHODS: Worst-case dose distributions were generated for each of 9 patients who experienced recurrence after concurrent chemotherapy and PSPT to 74 Gy(RBE) for stage III NSCLC by simulating and incorporating uncertainties associated with set-up, respiration-induced organ motion, and proton range in the planning process. The worst-case CT scans were then fused with the positron emission tomography (PET) scans to locate the recurrence. RESULTS: Although the volumes enclosed by the prescription isodose lines in the worst-case dose distributions were consistently smaller than enclosed volumes in the nominal plans, the target dose coverage was not significantly affected: only one patient had a recurrence outside the prescription isodose lines in the worst-case plan. CONCLUSIONS: PSPT is a relatively robust technique. Local recurrence was not associated with target underdosage resulting from estimated uncertainties in 8 of 9 cases.
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| Authors | Zhengfei Zhu, Wei Liu, Michael Gillin, Daniel R Gomez, Ritsuko Komaki, James D Cox, Radhe Mohan, Joe Y Chang |
| Journal | Radiation oncology (London, England) (Radiat Oncol) Vol. 9 Pg. 108 (May 06 2014) ISSN: 1748-717X [Electronic] England |
| PMID | 24886059 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, N.I.H., Extramural) |
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