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Inline Magnetic Fields Enhance Tumor Dose for Small Lung Cancers

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B Oborn

B Oborn1*, Y Ge2 , N Hardcastle3 , P Metcalfe4 , P Keall5 , (1) Illawarra Cancer Care Centre, Wollongong, NSW, (2) University of Sydney, University Of Sydney, NSW, (3) Royal North Shore Hospital, St. Leonards, ,(4) University of Wollongong, Wollongong, ,(5) University of Sydney, Sydney, Australia


WE-G-BRD-5 (Wednesday, July 15, 2015) 4:30 PM - 6:00 PM Room: Ballroom D

Purpose: To report on significant dose enhancement effects caused by magnetic fields aligned parallel to 6MV photon beam radiotherapy of small lung tumors. Findings are applicable to future inline MRI-guided radiotherapy systems.

Methods: 9 clinical lung plans were recalculated using Monte Carlo methods and external inline (parallel to the beam direction) magnetic fields of 0.5 T, 1.0 T and 3 T were included. Three plans were 6MV 3D-CRT and six were 6MV IMRT. The GTV's ranged from 0.8 cc to 73 cc, while the PTV ranged from 1 cc to 180 cc.

Results: The inline magnetic field has a moderate impact in lung dose distributions by reducing the lateral scatter of secondary electrons and causing a small local dose increase. Superposition of multiple small beams acts to superimpose the small dose increases and can lead to significant dose enhancements, especially when the GTV is low density. Two plans with very small, low mean density GTV's (<1 cc, ρ(mean)<0.35g/cc) showed uniform increases of 16% and 23% at 1 T throughout the PTV. Three plans with moderate mean density PTV's (3-13 cc, ρ(mean)=0.58-0.67 g/cc) showed 6% mean dose enhancement at 1 T in the PTV, however not uniform throughout the GTV/PTV. Replanning would benefit these cases. The remaining 5 plans had large dense GTV's (~ 1 g/cc) and so only a minimal (<2%) enhancement was seen. In general the mean dose enhancement at 0.5 T was 60% less than 1 T, while 5-50% higher at 3 T.

Conclusions: A paradigm shift in the efficacy of small lung tumor radiotherapy is predicted with future inline MRI-linac systems. This will be achieved by carefully taking advantage of the reduction of lateral electronic disequilibrium withing lung tissue that is induced naturally inside strong inline magnetic fields.

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