AUTHOR=Brevet Romain , Richter Daniel , Graeff Christian , Durante Marco , Bert Christoph TITLE=Treatment Parameters Optimization to Compensate for Interfractional Anatomy Variability and Intrafractional Tumor Motion JOURNAL=Frontiers in Oncology VOLUME=5 YEAR=2015 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2015.00291 DOI=10.3389/fonc.2015.00291 ISSN=2234-943X ABSTRACT=
Scanned ion beam therapy of lung tumors is severely limited in its clinical applicability by intrafractional organ motion, interference effects between beam and tumor motion (interplay), as well as interfractional anatomic changes. To compensate for dose deterioration caused by intrafractional motion, motion mitigation techniques, such as gating, have been developed. However, optimization of the treatment parameters is needed to further improve target dose coverage and normal tissue sparing. The aim of this study was to determine treatment-planning parameters that permit to recover good target coverage for each fraction of lung tumor treatments. For 9 lung tumor patients from MD Anderson Cancer Center (Houston, Texas), a total of 70 weekly time-resolved computed tomography (4DCT) datasets, which depict the evolution of the patient anatomy over the several fractions of the treatment, were available. Using the GSI in-house treatment planning system TRiP4D, 4D simulations were performed on each weekly 4DCT for each patient using gating and optimization of a single treatment plan based on a planning CT acquired prior to treatment. The impact on target dose coverage (