arXiv subjects

V. Wase

Publications and source records attributed to V. Wase.

2 recordsLinked to original sources

arXiv2024

FLASH-enabled Proton SBRT for a challenging case of spine metastasis

The FLASH effect, characterized by potential sparing of organs at risk (OAR) through ultra-high dose rate irradiation, has garnered significant attention for its capability to address indications previously untreatable at conventional dose rates (DR) with hypofractionated schemes. While considerable biological research is needed to understand the FLASH effect and determine the FLASH modifying factors (FMF) for individual OARs, exploratory treatment planning studies have also emerged. This study aims to show that spinal metastases are candidate treatment sites likely to benefit from this phenomenon and establish the requisite FMFs to achieve the protective FLASH effect. A conformal FLASH Proton SBRT plan was generated for a patient with spine metastasis in a research version of RayStation11B (RaySearch laboratories AB, Stockhom) on an IBA Proteus Plus system. Two oblique posterior beams were used in the plan. The prescribed dose to the CTV was set according to 3 different fractionation regimens: 5 fractions (fx) of 7 Gy, 8 fx of 5 Gy, and 10 fx of 4.2 Gy. Spot filtering and sorting techniques were applied to maximize the 5% pencil beam scanning DR in the spinal cord (SC). The FLASH effect was assumed to be observed within irradiated regions above 40 Gy/s and 4 Gy per fraction. The generated plans successfully ensure robust target coverage in each fraction. The volume of SC that does not comply with the clinical goal adheres to the FLASH effect conditions in each fraction. Depending on the aforementioned fractionation schemes used, a FMF of approximately 0.6 to 0.8 is necessary to enable such treatment in FLASH conditions. Our study demonstrates the potential of hypofractionated FLASH PT in treating spine metastasis while preserving SC integrity. This approach could enable more effective treatment of spinal metastases, potentially preventing SC compression and paralysis in these patients.

physics.med-ph↗

arXiv2023

Efficient proton arc optimization and delivery through energy layer pre-selection and post-filtering

Proton arc therapy (PAT) has emerged as a promising approach for improving dose distribution, but also enabling simpler and faster treatment delivery in comparison to conventional proton treatments. However, the delivery speed achievable in proton arc relies on dedicated algorithms, which currently do not generate plans with a clear speed-up and sometimes even result in increased delivery time. This study aims to address the challenge of minimizing delivery time through a hybrid method combining a fast geometry-based energy layer (EL) pre-selection with a dose-based EL filtering. Three methods of EL filtering were developed; The unrestricted method filters the lowest weighted EL while the SU gap filtering removes the EL around a new SU to minimize the gantry rotation braking. The SU filtering removes the lowest weighted group of EL that includes a SU. These filters were combined with the RayStation dynamic proton arc optimization framework (ELSA). Four bilateral oropharyngeal and four lung cancer patients' data were used for evaluation. Objective function values, target coverage robustness, organ-at-risk doses and NTCP evaluations, as well as comparisons to IMPT plans, were used to assess plan quality. The SU gap filtering algorithm performed best in five out of the eight cases, maintaining plan quality within tolerance while reducing beam delivery time, in particular for the oropharyngeal cohort. It achieved up to approximately 22% and 15% reduction in delivery time for oropharyngeal and lung treatment sites, respectively. The unrestricted filtering algorithm followed closely. In contrast, the SU filtering showed limited improvement, suppressing one or two SU without substantial delivery time shortening. Robust target coverage was kept within 1% of variation compared to the PAT baseline plan while organs-at-risk doses slightly decreased or kept about the same for all patients.

physics.med-ph↗