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Robustness of interlaced proton grid therapy plans against pencil-beam spot position variations
Stockholm University, Faculty of Science, Department of Physics.ORCID iD: 0000-0001-9039-4979
Stockholm University, Faculty of Science, Department of Physics.
(English)Manuscript (preprint) (Other academic)
National Category
Cancer and Oncology
Research subject
Medical Radiation Physics
Identifiers
URN: urn:nbn:se:su:diva-160426OAI: oai:DiVA.org:su-160426DiVA, id: diva2:1250397
Available from: 2018-09-24 Created: 2018-09-24 Last updated: 2018-09-24Bibliographically approved
In thesis
1. Interlaced proton grid therapy: development of an innovative radiation treatment technique
Open this publication in new window or tab >>Interlaced proton grid therapy: development of an innovative radiation treatment technique
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Spatially fractionated radiotherapy, also known as grid therapy (GRID), has been used for more than a century to try to treat several kinds of lesions. Yet, the grid technique remains a relatively unknown and uncommon treatment modality nowadays. Spatially fractionated beams, instead of conventional homogeneous fields, have been used to exploit the experimental finding that normal tissue can tolerate higher doses when smaller tissue volumes are irradiated. This increase in tolerance with reducing beam size is known as the dose-volume effect. Despite the fact that targets were given inhomogeneous dose distribution, sometimes with some volumes receiving close to no dose, good results in the form of shrinking of bulky tumors have been observed in palliative treatments. The biological processes responsible for this effect are still under discussion, with several possible causes. However, numerous experiments on mice, rats and pigs have confirmed the existence of such effect, which in turn motivates the present development of grid therapy.While mainly photons have been used in grid therapy, proton and ion grid therapies are also emerging as potential alternatives. In this work, an innovative form of grid therapy was proposed. Grids of proton beamlets were interlaced over a target volume with the intention of achieving two main objectives: (1) to keep the grid pattern (made of adjacent high and low doses) from the skin up to the vicinity of the target while (2) delivering nearly homogeneous dose to the target volume. This interlaced proton grid therapy was explored with the use of different beam sizes, from conventional sizes deliverable at modern proton facilities, down to millimeter sized beams. Other considerations that would prevent its clinical use, such as the variable relative biological effectiveness of protons or the use of cone beam computed tomography, were also evaluated. The overall aim was to assess if, and how, such treatment modality could be applied clinically, from a physics and dosimetry point of view. While it presented several theoretical advantages, its potential issues of concern and limitations were also evaluated.

Place, publisher, year, edition, pages
Stockholm: Department of Physics, Stockholm University, 2018. p. 65
Keywords
proton therapy, grid therapy, spatially fractionated therapy, interlacing
National Category
Cancer and Oncology
Research subject
Medical Radiation Physics
Identifiers
urn:nbn:se:su:diva-160427 (URN)978-91-7797-442-0 (ISBN)978-91-7797-443-7 (ISBN)
Public defence
2018-11-09, CCK Lecture Hall, Building R8, Karolinska University Hospital, Solna, Stockholm, 09:00 (English)
Opponent
Supervisors
Available from: 2018-10-17 Created: 2018-09-24 Last updated: 2018-10-16Bibliographically approved

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