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Dosimetric Impact of Rotational Error On the Target Coverage in IMPT Lung Cancer Plans

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S Rana

S Rana*, Y Zheng , ProCure Proton Therapy Center, Oklahoma City, OK

Presentations

SU-E-T-333 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall


Purpose: The main purpose of this study was to investigate the impact of rotational (yaw, roll, and pitch) error on the planning target volume (PTV) coverage in lung cancer plans generated by intensity modulated proton therapy (IMPT).

Methods: In this retrospective study, computed tomography (CT) dataset of previously treated lung case was used. IMPT plan were generated on the original CT dataset using left-lateral (LL) and posterior-anterior (PA) beams for a total dose of 74 Gy[RBE] with 2 Gy[RBE] per fraction. In order to investigate the dosimetric impact of rotational error, 12 new CT datasets were generated by re-sampling the original CT dataset for rotational (roll, yaw, and pitch) angles ranged from -5° to +5°, with an increment of 2.5°. A total of 12 new IMPT plans were generated based on the re-sampled CT datasets using beam parameters identical to the ones in the original IMPT plan. All treatment plans were generated in XiO treatment planning system. The PTV coverage (i.e., dose received by 95% of the PTV volume, D95) in new IMPT plans were then compared with the PTV coverage in the original IMPT plan.

Results: Rotational errors caused the reduction in the PTV coverage in all 12 new IMPT plans when compared to the original IMPT lung plan. Specifically, the PTV coverage was reduced by 4.94% to 50.51% for yaw, by 4.04% to 23.74% for roll, and by 5.21% to 46.88% for pitch errors.

Conclusion: Unacceptable dosimetric results were observed in new IMPT plans as the PTV coverage was reduced by up to 26.87% and 50.51% for rotational error of 2.5° and 5°, respectively. Further investigation is underway in evaluating the PTV coverage loss in the IMPT lung cancer plans for smaller rotational angle change.



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