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Effective Adaptive DMLC Gated Radiotherapy with OAR Sparing

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Y Chen

Y Chen1,2 ,H Wu1*, Z Zhou2 , MinGeorge Sandison3,(1) IUPUI, Indianapolis, IN, (2) Nanjing University of Aeronautics and Astronautics (NUAA), Nanjing, Jiangsu,(3)University of Washington


SU-E-J-59 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Patient respiratory motion degrades the effectiveness of cancer radiation treatment. Advanced respiratory gating delivers radiation dose accurately yet with elongated treatment time. The goal of this research is to propose a novel adaptive dMLC dynamic gating with high delivery efficiency and precision.

The dose delivery of dMLC is aided by simultaneous tracking of tumor and organ at risk (OAR). The leaf opening/closing will follow the motion trajectory of the tumor while sparing the OAR. The treatment beam turns on only when there is no overlapping between OAR and tumor in BEV. A variety of evaluation metrics were considered and calculated, including duty cycle, beam toggling rate, and direct irradiation avoidance to OAR, under various combinations of different tumor margins and the distance between the centers of the tumor and OAR in BEV (expressed as dx).

Retrospective simulation was performed to investigate the feasibility and superiority of this technique using four groups of synchronized tumor and OAR motion data. The simulation results indicate that the tumor and OAR motion patterns and their relative positions are the dominant influential factors. The duty cycle can be greater than 96.71% yet can be as low as 6.69% depending different motion groups. This proposed technique provides good OAR protection, especially for such cases with low duty cycle for which as high as 77.71% maximal direct irradiation to OAR can be spared. Increasing dx improves the duty cycle (treatment efficiency) and provides better OAR volume sparing, whereas, that of the tumor margins has the opposite influence.

This real-time adaptive dMLC gated radiation treatment with synchronous tumor and OAR tracking has inherent accurate dose delivery to tumor with reduced treatment time. In addition, the OAR protection capability make it an outstanding potential treatment strategy for mobile tumors.

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