4-Dimensional Treatment Planning of Lung Tumors

Lung Cancer

• 1 out of 14 people will be diagnosed with lung cancer at some point in their life!

• 90% of lung cancer is caused by SMOKING.

5 years after diagnosis, only 16% survive!

Treatment Options

• Surgery• Chemotherapy• Radiation Therapy–Photons–Protons

Photons v. Protons

WIP Brown Bag March 3, 2009Chen, Mori, Sharp

More distal lung is irradiated

1

Accumulated doseDeformed doseOriginal

Room view Organ view Voxel view

LungEUD1 Analysis

GTY ChenAshley Rubenstein et al

September 28, 2010

EUD1 Fovia

Ant Field GIF no distal margin

Post Field GIF

Observations

• With post field, there is range perturbation distal to target during motion

• More normal lung is irradiated • Distal lung density is altered; so deeper

geometric penetration. • Therefore EUD could change in 4D planning vs

3D planning. Magnitude depend on degree of motion and compensator design.

EUD2 Analysis

GTYC / AERSeptember 28, 2010

LPO single field dose Gif

Post Obliques 2F plan GIF

EUD3 Analysis

Sept 28 2010

Single field dose distribution

Single field dose distribution

Single field dose distribution

Plan

• 4 field plan• Quite robust to motion!• Use more fields in proton lung!