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Three-Dimensional Carcinogenic Maps Induced by Photons and Protons

V Manem

V Manem*, H Paganetti , Massachusetts General Hospital, Boston, MA


SU-E-T-752 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose:Evaluate the excess relative risk (ERR) induced by photons and protons in each voxel of the lung, and display it as a three-dimensional map, known as the ERRM (i.e. excess relative risk map) along with the dose distribution map. In addition, we also study the effect of variations in the linear energy transfer (LET) distribution on ERRM for a given proton plan.
Methods:The excess relative risk due to radiation is estimated using the initiation-inactivation-proliferation formalism. This framework accounts for three biological phenomenon: mutation induction, cell kill and proliferation. Cell kill and mutation induction are taken as a function of LET using experimental data. LET distributions are calculated using a Monte Carlo algorithm. ERR is then estimated for each voxel in the organ, and displayed as a three dimensional carcinogenic map.
Results:The differences in the ERR’s between photons and protons is seen from the three-dimensional ERR map. In addition, we also varied the LET of a proton plan and observed the differences in the corresponding ERR maps demonstrating variations in the ERR maps depend on features of a proton plan. Additionally, our results suggest that any two proton plans that have the same integral dose does not necessarily imply identical ERR maps, and these changes are due to the variations in the LET distribution map.
Conclusion:Clinically, it is important to have a three dimensional display of biological end points. This study is an effort to introduce 3D ERR maps into the treatment planning workflow for certain sites such as pediatric head and neck tumors.

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