Optimal combined proton-photon therapy schemes based on the standard BED model

Optimal combined proton-photon therapy schemes based on the standard BED model

ten Eikelder, S.C.M. (Tilburg University)
Den Hertog, D. (Tilburg University)
Bortfeld, T. (Massachusetts General Hospital)
Perko, Z. (TU Delft RST/Reactor Physics and Nuclear Materials; TU Delft RST/Fundamental Aspects of Materials and Energy; Physics Research Group; Massachusetts General Hospital)

2019

This paper investigates the potential of combined proton-photon therapy schemes in radiation oncology, with a special emphasis on fractionation. Several combined modality models, with and without fractionation, are discussed, and conditions under which combined modality treatments are of added value are demonstrated analytically and numerically. The combined modality optimal fractionation problem with multiple normal tissues is formulated based on the biologically effective dose (BED) model and tested on real patient data. Results indicate that for several patients a combined modality treatment gives better results in terms of biological dose (up to14.8% improvement) than single modality proton treatments. For several other patients, a combined modality treatment is found that offers an alternative to the optimal single modality proton treatment, being only marginally worse but using signifcantly fewer proton fractions, putting less pressure on the limited availability of proton slots. Overall, these results indicate that combined modality treatments can be a viable option, which is expected to become more important as proton therapy centers are spreading but the proton therapy price tag remains high.

biologically effective dose (BED)
intensity-modulated radiation therapy (IMRT)
multi-modality treatment
optimization
proton therapy

http://resolver.tudelft.nl/uuid:975b11c5-3b96-4e02-8129-ec2171c0114b

https://doi.org/10.1088/1361-6560/aafe52

2019-09-11

0031-9155

Physics in Medicine and Biology, 64 (6)

Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.

Institutional Repository

journal article

© 2019 S.C.M. ten Eikelder, D. Den Hertog, T. Bortfeld, Z. Perko