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Very high-energy electron ( VHEE) beams in radiation therapy; Treatment plan comparison between VHEE, VMAT, and PPBS.

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Title: Very high-energy electron ( VHEE) beams in radiation therapy; Treatment plan comparison between VHEE, VMAT, and PPBS.
Authors: Schüler, Emil1, Eriksson, Kjell2, Hynning, Elin2, Hancock, Steven L.1, Hiniker, Susan M.1, Bazalova‐Carter, Magdalena3, Wong, Tony4, Le, Quynh‐Thu1, Loo, Billy W.1 bwloo@stanford.edu, Maxim, Peter G.1 pmaxim@stanford.edu
Source: Medical Physics. Jun2017, Vol. 44 Issue 6, p2544-2555. 12p.
Subjects: Radiotherapy, Therapeutic use of electron beams, Electron optics, Medical radiology, Electromagnetic waves
Abstract: Purpose The aim of this study was to evaluate the performance of very high-energy electron beams ( VHEE) in comparison to clinically derived treatment plans generated with volumetric modulated arc therapy ( VMAT) and proton pencil beam scanning ( PPBS) technology. We developed a custom optimization script that could be applied automatically across modalities to eliminate operator bias during IMRT optimization. Methods Four clinical cases were selected (prostate cancer, lung cancer, pediatric brain tumor, and head and neck cancer ( HNC)). The VHEE beams were calculated in the EGSnrc/ DOSXYZnrc Monte Carlo code for 100 and 200 MeV beams. Treatment plans with VHEE, VMAT, and PPBS were optimized in a research version of RayStation using an in-house developed script to minimize operator bias between the different techniques. Results The in-house developed script generated similar or superior plans to the clinically used plans. In the comparisons between the modalities, the integral dose was lowest for the PPBS-generated plans in all cases. For the prostate case, the 200 MeV VHEE plan showed reduced integral dose and reduced organ at risk ( OAR) dose compared to the VMAT plan. For all other cases, both the 100 and the 200 MeV VHEE plans were superior to the VMAT plans, and the VHEE plans showed better conformity and lower spinal cord dose in the pediatric brain case and lower brain stem dose in the HNC case when compared to the PPBS plan. Conclusions The automated optimization developed in this study generated similar or superior plans as compared to the clinically used plan and represents an unbiased approach to compare treatment plans generated for different modalities. In the present study, we also show that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases, and VHEE plans can even achieve reductions in OAR doses compared to PPBS plans for shallow targets. With increased VHEE energy, better conformity and even higher reductions in mean OAR doses are achieved. On the whole, VHEE was intermediate between photon VMAT and PPBS for OAR sparing. [ABSTRACT FROM AUTHOR]
Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: Very high-energy electron ( VHEE) beams in radiation therapy; Treatment plan comparison between VHEE, VMAT, and PPBS.
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  Data: <searchLink fieldCode="AR" term="%22Schüler%2C+Emil%22">Schüler, Emil</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Eriksson%2C+Kjell%22">Eriksson, Kjell</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Hynning%2C+Elin%22">Hynning, Elin</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Hancock%2C+Steven+L%2E%22">Hancock, Steven L.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Hiniker%2C+Susan+M%2E%22">Hiniker, Susan M.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Bazalova‐Carter%2C+Magdalena%22">Bazalova‐Carter, Magdalena</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Wong%2C+Tony%22">Wong, Tony</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Le%2C+Quynh‐Thu%22">Le, Quynh‐Thu</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Loo%2C+Billy+W%2E%22">Loo, Billy W.</searchLink><relatesTo>1</relatesTo><i> bwloo@stanford.edu</i><br /><searchLink fieldCode="AR" term="%22Maxim%2C+Peter+G%2E%22">Maxim, Peter G.</searchLink><relatesTo>1</relatesTo><i> pmaxim@stanford.edu</i>
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  Data: <searchLink fieldCode="JN" term="%22Medical+Physics%22">Medical Physics</searchLink>. Jun2017, Vol. 44 Issue 6, p2544-2555. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Radiotherapy%22">Radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutic+use+of+electron+beams%22">Therapeutic use of electron beams</searchLink><br /><searchLink fieldCode="DE" term="%22Electron+optics%22">Electron optics</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+radiology%22">Medical radiology</searchLink><br /><searchLink fieldCode="DE" term="%22Electromagnetic+waves%22">Electromagnetic waves</searchLink>
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  Data: Purpose The aim of this study was to evaluate the performance of very high-energy electron beams ( VHEE) in comparison to clinically derived treatment plans generated with volumetric modulated arc therapy ( VMAT) and proton pencil beam scanning ( PPBS) technology. We developed a custom optimization script that could be applied automatically across modalities to eliminate operator bias during IMRT optimization. Methods Four clinical cases were selected (prostate cancer, lung cancer, pediatric brain tumor, and head and neck cancer ( HNC)). The VHEE beams were calculated in the EGSnrc/ DOSXYZnrc Monte Carlo code for 100 and 200 MeV beams. Treatment plans with VHEE, VMAT, and PPBS were optimized in a research version of RayStation using an in-house developed script to minimize operator bias between the different techniques. Results The in-house developed script generated similar or superior plans to the clinically used plans. In the comparisons between the modalities, the integral dose was lowest for the PPBS-generated plans in all cases. For the prostate case, the 200 MeV VHEE plan showed reduced integral dose and reduced organ at risk ( OAR) dose compared to the VMAT plan. For all other cases, both the 100 and the 200 MeV VHEE plans were superior to the VMAT plans, and the VHEE plans showed better conformity and lower spinal cord dose in the pediatric brain case and lower brain stem dose in the HNC case when compared to the PPBS plan. Conclusions The automated optimization developed in this study generated similar or superior plans as compared to the clinically used plan and represents an unbiased approach to compare treatment plans generated for different modalities. In the present study, we also show that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases, and VHEE plans can even achieve reductions in OAR doses compared to PPBS plans for shallow targets. With increased VHEE energy, better conformity and even higher reductions in mean OAR doses are achieved. On the whole, VHEE was intermediate between photon VMAT and PPBS for OAR sparing. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1002/mp.12233
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      – SubjectFull: Radiotherapy
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      – SubjectFull: Therapeutic use of electron beams
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      – SubjectFull: Medical radiology
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