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!