Abstract:
:Intrafractional motion and interfractional changes affect the accuracy of the delivered dose in radiotherapy, particularly in charged-particle radiotherapy. Most recent studies are focused on intrafractional motion (respiratory motion). Here, we report a quantitative simulation analysis of the effects of interfractional changes on water-equivalent pathlength (WEL) in charged-particle lung therapy. Serial four-dimensional (4D) CT scans were performed under free breathing conditions; the time span between the first and second 4DCT scans was five weeks. We quantified WEL changes between the first and second CT scans due to interfractional changes (tumor shrinkage and tissue density changes) and compared the particle-beam-stopping point between the serial 4DCT scans with use of the same initial bolus. Both tumor-shrinkage and lung-density changes were observed in a single patient over the course of therapy. The lung density decreased by approximately 0.1 g/cm(3) between the first and second-CT scans, resulting in a 1.5 cm WEL changes. Tumor shrinkage resulted in approximately 3 cm WEL changes. If the same initial bolus and plan were used through the treatment course, an unexpected significant beam overshoot would occur by interfractional changes due to tumor shrinkage and lung density variation.
journal_name
J Radiat Resjournal_title
Journal of radiation researchauthors
Mori S,Lu HM,Wolfgang JA,Choi NC,Chen GTdoi
10.1269/jrr.09032subject
Has Abstractpub_date
2009-11-01 00:00:00pages
513-9issue
6eissn
0449-3060issn
1349-9157pii
JST.JSTAGE/jrr/09032journal_volume
50pub_type
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