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. 2020 Dec;21(12):96-108.
doi: 10.1002/acm2.13075. Epub 2020 Nov 5.

Proton vs Hyperarc™ radiosurgery: A planning comparison

A Boczkowski  1 , P Kelly  2 , S L Meeks  2 , K Erhart  3 , F J Bova  1 , T R Willoughby  1
Affiliations

Proton vs Hyperarc™ radiosurgery: A planning comparison

A Boczkowski et al. J Appl Clin Med Phys. 2020 Dec.

Abstract

For many patients, stereotactic radiosurgery (SRS) offers a minimally invasive, curative option when surgical techniques are not possible. To date, the literature supporting the efficacy and safety of SRS treatment techniques uses photon beams. However, with the number of proton therapy facilities exponentially growing and the favorable physical properties of proton beam radiation therapy, there is an opportunity to develop proton therapy techniques for SRS. The goal of this paper is to determine the ability of clinical proton treatment planning systems to model small field dosimetry accurately and to compare various planning metrics used to evaluate photon SRS to determine the optimum beam configurations and settings for proton SRS (PSRS) treatment plans. Once established, these plan settings were used to perform a planning comparison on a variety of different SRS cases and compare SRS metrics between the PSRS plans and HyperArc™ (VMAT) SRS plans.

Keywords: HyperArc; Proton radiosurgery; planning.

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Figures

Fig. 1
Fig. 1
Example shaped beam arrangements for the proton plans. (a) 3 beam (b) 9 beam and (c) 15 beam arrangements. Top image showing a left lateral view and bottom image showing an anterior view
Fig. 2
Fig. 2
Water tank depth dose measurement results comparing different aperture sizes for varying proton ranges, all measurements used a modulation of 3 cm d’ refers to the diameter opening of the aperture used
Fig. 3
Fig. 3
Comparison of lateral penumbra as a function of proton range comparison between film and treatment planning system
Fig. 4
Fig. 4
(a) and (b) Lateral and distal penumbra as measured between Prescription Isodose line and ½ of the Prescription isodose line for various isodose lines. (All lines are normalized to Max Dose)
Fig. 5
Fig. 5
Number of beams experiment with & without compensators, comparing CGIc (a), CGIg (b), CGI (c), and ID (d)
Fig. 6
Fig. 6
Number of beams vs aperture margin, comparing CGIc (a), CGIg (b), CGI (c), and ID (d)
Fig. 7
Fig. 7
Isodose lines comparing two different planning techniques for Patient 2 and Patient 5
Fig. 8
Fig. 8
Dose volume histogram (DVH) for GTV and Normal tissue comparing volumetric modulated arc therapy stereotactic radiosurgery (SRS) to PSRS
See this image and copyright information in PMC

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