Academic Journal

Reducing the dose delivered to major intracranial blood vessels in brain radiotherapy using spot-scanning proton arc therapy.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Reducing the dose delivered to major intracranial blood vessels in brain radiotherapy using spot-scanning proton arc therapy.
Συγγραφείς: Liu P; Department of Radiation Oncology, William Beaumont University Hospital, Corewell Health, Royal Oak, Michigan, USA.; Medical Physics, School of Medicine, Wayne State University, Detroit, Michigan, USA., Tattenberg S; Laurentian University, Sudbury, Ontario, Canada.; TRIUMF, Vancouver, British Columbia, Canada., Cong X; Department of Radiation Oncology, William Beaumont University Hospital, Corewell Health, Royal Oak, Michigan, USA., Chen PY; Department of Radiation Oncology, William Beaumont University Hospital, Corewell Health, Royal Oak, Michigan, USA., Ding X; Department of Radiation Oncology, William Beaumont University Hospital, Corewell Health, Royal Oak, Michigan, USA.; Corewellhealth William Beaumont University Hospital, Royal Oak, USA., Hammi A; Technical University of Dortmund, Dortmund, Germany.
Πηγή: Journal of applied clinical medical physics [J Appl Clin Med Phys] 2026 Sep; Vol. 27 (9), pp. e70780.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley on behalf of American Association of Physicists in Medicine Country of Publication: United States NLM ID: 101089176 Publication Model: Print Cited Medium: Internet ISSN: 1526-9914 (Electronic) Linking ISSN: 15269914 NLM ISO Abbreviation: J Appl Clin Med Phys Subsets: MEDLINE
Imprint Name(s): Publication: 2017- : Malden, MA : Wiley on behalf of American Association of Physicists in Medicine
Original Publication: Reston, VA : American College of Medical Physics, c2000-
Ιατρικοί όροι (MeSH): Proton Therapy*/methods , Radiotherapy Planning, Computer-Assisted*/methods , Brain Neoplasms*/radiotherapy , Glioblastoma*/radiotherapy , Radiotherapy, Intensity-Modulated*/methods , Organs at Risk*/radiation effects , Blood Vessels*/radiation effects, Humans ; Radiotherapy Dosage ; Linear Energy Transfer ; Prognosis
Περίληψη: Background: Glioblastoma (GBM) patients have poor clinical prognoses, which may partially be explainable by correlations between radiation-induced killing of circulating blood cells (CBCs) and worse clinical outcomes. Proton radiotherapy is currently delivered via intensity-modulated proton therapy (IMPT), for which the target is irradiated from a few different angles. Spot-scanning proton arc therapy (SPArc), for which the target is irradiated from arc trajectories, is associated with dosimetric benefits, and the first SPArc treatments of head-and-neck cancer patients have now been reported. However, since SPArc increases the low-dose bath, concerns have been raised about potentially higher killing of CBC.
Purpose: This study aims to evaluate and compare blood vessel dose and dose-averaged linear energy transfer (LETd) distributions between IMPT and SPArc, with and without blood vessel sparing, in patients with GBM.
Methods: For 10 GBM patients, patient-specific cerebrovasculature models were developed, and IMPT and SPArc treatment plans were created according to current clinical standards (IMPTConv and SPArcConv) and with sparing of delineated blood vessels (IMPTSparing and SPArcSparing) for every patient. Dose and LETd distributions were then compared across all treatment plans.
Results: While treatment plans maintained comparable target coverage, blood vessel sparing significantly reduced the mean dose to delineated blood vessels, with values of 6.5 ± 2.9 Gy(RBE) for IMPTConv, 5.3 ± 2.3 Gy(RBE) for IMPTSparing, 5.6 ± 2.2 Gy(RBE) for SPArcConv, and 3.8 ± 1.6 Gy(RBE) for SPArcSparing. The dose within the 10% of blood vessel volume receiving the highest dose (D10%) was 29.5 ± 13.4 Gy(RBE) for IMPTConv, 23.2 ± 11.0 Gy(RBE) for IMPTSparing, 24.5 ± 12.6 Gy(RBE) for SPArcConv, and 13.4 ± 8.7 Gy(RBE) for SPArcSparing.
Conclusions: Implementation of blood vessel sparing resulted in successful reductions in blood vessel dose metrics while preserving target coverage, and SPArc further reduced blood vessel dose metrics compared with IMPT, with the potential to reduce radiation-induced lymphopenia and improve clinical outcomes.
(© 2026 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.)
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Grant Information: R01 CA301448 United States CA NCI NIH HHS; R01CA301448 United States CA NCI NIH HHS
Contributed Indexing: Keywords: blood dose; glioblastoma; lymphopenia; proton arc therapy; proton therapy
Entry Date(s): Date Created: 20260910 Date Completed: 20260910 Latest Revision: 20260915
Update Code: 20260915
PubMed Central ID: PMC13559178
DOI: 10.1002/acm2.70780
PMID: 42717666
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1526-9914
DOI:10.1002/acm2.70780