Impact of anatomical changes on simulated proton arc therapy and intensity‐modulated proton therapy for lung cancer
6 affiliations
- 1Applied Nuclear Technology in Geosciences Key Laboratory of Sichuan Province Chengdu University of Technology Chengdu China
- 2Department of Radiation Oncology Sichuan Clinical Research Center for Cancer Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China Chengdu China
- 3School of Physics University of Electronic Science and Technology Chengdu China
- 4Institute of Nuclear Science and Technology, Sichuan University Chengdu China
- 5Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
- 6Department of Radiation Oncology, Corewell Health William Beaumont University Hospital Royal Oak Michigan USA
Abstract
Purpose: : During lung cancer radiotherapy, inter‐fractional anatomical changes may cause the delivered dose to deviate from the primary plan, affecting tumor control and increasing the risk of normal tissue damage. This study aims to evaluate the impact of anatomical changes on the dosimetric and radiobiological performance of simulated proton arc therapy (sPAT) versus intensity‐modulated proton therapy (IMPT) for lung cancer patients under patient‐specific anatomical changes.
Methods: : Data from 21 lung cancer patients were retrospectively analyzed. The prescribed dose for all patients was 6000 cGy (relative biological effectiveness, RBE). Each patient with a primary planning computed tomography (pCT) and a mid‐treatment adaptive‐planning CT (aCT) acquired at a median of 29 days into treatment due to notable tumor volume changes. Primary plans for sPAT and IMPT were designed on the pCT. After rigid registration of the pCT and aCT, non‐adaptive plans (sPATp‐a, IMPTp‐a) were generated by directly recalculating the doses of the primary plans on the aCT. The comparison evaluated the dosimetric impact of anatomical changes by comparing non‐adaptive plans (sPATp‐a vs. IMPTp‐a). Dose‐volume histogram (DVH) parameters for targets and organs at risk (OARs) and tumor control probability (TCP) and normal tissue complication probability (NTCP) were evaluated.
Results: : For the primary plans, sPAT and IMPT achieved similar target coverage, while the doses to OARs were generally lower in sPATp. Under anatomical changes, both non‐adaptive plans exhibited a decrease in target coverage, sPATp‐a achieved a D95% of 5567.57 cGy[RBE] compared with 5423.33 cGy[RBE] for IMPTp‐a (p < 0.001), indicating that sPAT better preserved target coverage. Compared with the primary plans, sPATp‐a and IMPTp‐a exhibited TCP reductions of 5.83% and 8.07%, respectively.
Conclusions: : Compared with IMPT, sPAT exhibits enhanced robustness against inter‐fractional anatomical changes occurring in lung‐cancer radiotherapy.
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BibTeX
@article{chen2026impact,
title = {{Impact of anatomical changes on simulated proton arc therapy and intensity‐modulated proton therapy for lung cancer}},
author = {Wenguang Chen and Feng Yang and Fanrui Zeng and Hao Guo and Yuankang Xu and Tianyu Zhang and Junxiang Wu and Da Zhang and Gang Liu and Xuanfeng Ding and Xianliang Wang},
journal = {Journal of Applied Clinical Medical Physics},
year = {2026},
month = oct,
doi = {10.1002/acm2.70881},
url = {https://doi.org/10.1002/acm2.70881},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of anatomical changes on simulated proton arc therapy and intensity‐modulated proton therapy for lung cancer
AU - Wenguang Chen
AU - Feng Yang
AU - Fanrui Zeng
AU - Hao Guo
AU - Yuankang Xu
AU - Tianyu Zhang
AU - Junxiang Wu
AU - Da Zhang
AU - Gang Liu
AU - Xuanfeng Ding
AU - Xianliang Wang
PY - 2026
DA - 2026/10/26
JO - Journal of Applied Clinical Medical Physics
DO - 10.1002/acm2.70881
UR - https://doi.org/10.1002/acm2.70881
AB - Purpose: : During lung cancer radiotherapy, inter‐fractional anatomical changes may cause the delivered dose to deviate from the primary plan, affecting tumor control and increasing the risk of normal tissue damage. This study aims to evaluate the impact of anatomical changes on the dosimetric and radiobiological performance of simulated proton arc therapy (sPAT) versus intensity‐modulated proton therapy (IMPT) for lung cancer patients under patient‐specific anatomical changes. Methods: : Data from 21 lung cancer patients were retrospectively analyzed. The prescribed dose for all patients was 6000 cGy (relative biological effectiveness, RBE). Each patient with a primary planning computed tomography (pCT) and a mid‐treatment adaptive‐planning CT (aCT) acquired at a median of 29 days into treatment due to notable tumor volume changes. Primary plans for sPAT and IMPT were designed on the pCT. After rigid registration of the pCT and aCT, non‐adaptive plans (sPATp‐a, IMPTp‐a) were generated by directly recalculating the doses of the primary plans on the aCT. The comparison evaluated the dosimetric impact of anatomical changes by comparing non‐adaptive plans (sPATp‐a vs. IMPTp‐a). Dose‐volume histogram (DVH) parameters for targets and organs at risk (OARs) and tumor control probability (TCP) and normal tissue complication probability (NTCP) were evaluated. Results: : For the primary plans, sPAT and IMPT achieved similar target coverage, while the doses to OARs were generally lower in sPATp. Under anatomical changes, both non‐adaptive plans exhibited a decrease in target coverage, sPATp‐a achieved a D95% of 5567.57 cGy[RBE] compared with 5423.33 cGy[RBE] for IMPTp‐a (p < 0.001), indicating that sPAT better preserved target coverage. Compared with the primary plans, sPATp‐a and IMPTp‐a exhibited TCP reductions of 5.83% and 8.07%, respectively. Conclusions: : Compared with IMPT, sPAT exhibits enhanced robustness against inter‐fractional anatomical changes occurring in lung‐cancer radiotherapy.
SN - 1526-9914
ER -