Dataset related to article "Critical appraisal of the potential role of intensity modulated proton therapy in the hypofractionated treatment of advanced hepatocellular carcinoma"

This record contains raw data related to article "Critical appraisal of the potential role of intensity modulated proton therapy in the hypofractionated treatment of advanced hepatocellular carcinoma"

PURPOSE:

To investigate the role of intensity modulated proton therapy (IMPT) for advanced hepatocellular carcinoma in comparison with volumetric modulated arc therapy (VMAT).

METHODS:

An in-silico planning study was performed on 20 patients. The prescription dose was 60Gy in 6 fractions. Patients were planned with abdominal compression. IMPT plans were optimized with or without the inclusion of CT calibration (3%) and isocenter positioning (2,4,6mm) uncertainties. Plan robustness was appraised comparing rubust optimized plans vs standard plans and also in terms of the worst-case scenario. VMAT plans were optimized for 10FFF photon beams using 2 partial arcs.

RESULTS:

Target coverage was fully achieved by both VMAT and IMPT plans with a significant improvement in homogeneity (~25%) with IMPT. Integral dose was reduced of ~60% with IMPT while the conformality of the dose distributions was similar among techniques. The sparing of the organs at risk was strongly improved with IMPT although all clinical objectives were met for both techniques. The inclusion of the uncertainties in the optimization lead to some deterioration in the target dose homogeneity (from 40 to 80% worse with 4 or 6mm position uncertainty) while none of the coverage parameters or OAR objective was violated. The worst-case scenario analysis demonstrated the risk of a major target underdosage only in the case of the most extreme errors (6mm) with D98% in average ~12% lower than the threshold.

CONCLUSION:

IMPT with the support of abdominal compression, can be considered a viable solution also for advanced hepatocellular carcinoma patients. Great care shall be put in the minimization of the residual respiration and positioning uncertainties but the dosimetric advantage for organs at risk and the relative robustness on target coverage are promising factors.

本数据集包含与题为《调强质子治疗在晚期肝细胞癌大分割治疗中的潜在价值批判性评估》的研究相关的原始数据。

**研究目的**：对比调强质子治疗（intensity modulated proton therapy, IMPT）与容积调强弧形治疗（volumetric modulated arc therapy, VMAT）在晚期肝细胞癌治疗中的应用价值。

**研究方法**：本研究针对20例患者开展计算机模拟计划研究。处方剂量为60Gy，分6次给予。所有患者均采用腹部压迫体位进行计划设计。IMPT计划在纳入或不纳入CT校准误差（3%）及等中心位置误差（2、4、6mm）的情况下进行优化。通过对比鲁棒优化计划与标准计划，并结合最坏场景分析，评估计划的鲁棒性。VMAT计划采用2个部分弧野，针对10FFF光子束进行优化。

**研究结果**：VMAT与IMPT计划均实现了完整的靶区覆盖，其中IMPT计划的靶区均匀性显著提升约25%。IMPT计划的积分剂量较VMAT降低约60%，而两种技术的剂量分布适形度相当。尽管两种技术均满足所有临床目标，但IMPT对危及器官的保护效果显著更优。在优化过程中纳入误差会导致靶区剂量均匀性出现一定程度的下降（当位置误差为4或6mm时，均匀性下降40%~80%），但未出现靶区覆盖参数或危及器官目标被违反的情况。最坏场景分析显示，仅在最极端的误差（6mm）情况下，才存在靶区显著剂量不足的风险，此时D98%平均较阈值低约12%。

**研究结论**：结合腹部压迫技术的IMPT方案，可被视为晚期肝细胞癌患者的可行治疗选择。尽管仍需尽可能降低残余呼吸及位置误差带来的影响，但IMPT在危及器官保护方面的剂量学优势，以及其在靶区覆盖上的相对鲁棒性，均为极具前景的应用优势。