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Planning for Proton Pencil Beam Scanning (PBS): Applications of Gradient Optimization for Field Matching

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H Lin

H Lin*, M Kirk , H Zhai , X Ding , H Liu , C Hill-Kayser , R Lustig , Z Tochner , C Deville , N Vapiwala , J McDonough , S Both , Univ Pennsylvania, Philadelphia, PA


SU-E-T-262 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: To propose the gradient optimization(GO) approach in planning for matching proton PBS fields and present two commonly used applications in our institution.

Methods: GO is employed for PBS field matching in the scenarios that when the size of the target is beyond the field size limit of the beam delivery system or matching is required for beams from different angles to either improve the sparing of important organs or to pass through a short and simple beam path. Overlap is designed between adjacent fields and in the overlapped junction, the dose was optimized such that it gradually decreases in one field and the decrease is compensated by increase from another field. Clinical applications of this approach on craniospinal irradiation(CSI) and whole pelvis treatment were presented. Mathematical model was developed to study the relationships between dose errors, setup errors and junction lengths.

Results: Uniform and conformal dose coverage to the entire target volumes was achieved for both applications using GO approach. For CSI, the gradient matching (6.7cm junction) between fields overcame the complexity of planning associated with feathering match lines. A slow dose gradient in the junction area significantly reduced the sensitivity of the treatment to setup errors. For whole pelvis, gradient matching (4cm junction) between posterior fields for superior target and bilateral fields for inferior target provided dose sparing to organs such as bowel, bladder and rectum. For a setup error of 3 mm in longitudinal direction from one field, mathematical model predicted dose errors of 10%, 6% and 4.3% for junction length of 3, 5 and 7cm.

Conclusion: This GO approach improves the quality of the PBS treatment plan with matching fields while maintaining the safety of treatment delivery relative to potential misalignments.

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