Biological dose-based fractional dose optimization of Bragg peak FLASH-RT for lung cancer treatment.

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Tác giả: Yu Chang, Shuoyan Chen, Muyu Liu, Xu Liu, Bo Pang, Bin Qin, Hong Quan, Wei Wang, Zhiyong Yang, Yiling Zeng, Qi Zhang

Ngôn ngữ: eng

Ký hiệu phân loại: 264.021 Texts of calendars and ordos

Thông tin xuất bản: United States : Medical physics , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 208220

BACKGROUND: The FLASH effect is dose-dependent, and fractional dose optimization may enhance it, improving normal tissue sparing. PURPOSE: This study investigates the performance of fractional dose optimization in enhancing normal tissue sparing for Bragg peak FLASH radiotherapy (FLASH-RT). METHODS: 15 lung cancer patients, including eight with peripherally located tumors and seven with centrally located tumors, were retrospectively analyzed. A uniform fractionation prescription of 50 Gy in five fractions was utilized, corresponding to a biological equivalent dose (BED) of 100 Gy, calculated using an α/β value of 10 Gy. For each patient, uniform (UFD) and nonuniform fractional dose (non-UFD) plans were designed. In UFD FLASH plans, five multi-energy Bragg peak beams were optimized using single-field optimization, each delivering 10 Gy to the target. In non-UFD FLASH plans, fractional doses were optimized to enhance sparing effects while ensuring the target received a BED comparable to UFD plans. A dose-dependent FLASH enhancement ratio (FER) was integrated with the BED to form the FER-BED metric to compare the UFD and non-UFD plans. An α/β value of 3 Gy was applied for normal tissues in the calculations. RESULTS: Bragg peak FLASH plans showed high dose conformality for both peripheral and central tumors, with all plans achieving a conformality index (the ratio of the volume receiving the prescribed dose to the CTV volume) below 1.2. In non-UFD plans, fractional doses ranged from 5.0 Gy to 20.0 Gy. Compared to UFD plans, non-UFD plans achieved similar BED coverage (BED CONCLUSIONS: Bragg peak FLASH-RT achieved high dose conformality for both peripheral and central tumors. Fractional dose optimization, using a single beam per fraction delivery mode, enhanced normal tissue sparing by leveraging both fractionation and FLASH effects.
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