A Proton Treatment Planning Method for Combining FLASH and Spatially Fractionated Radiation Therapy to Enhance Normal Tissue Protection
Fuente:
arXiv
Enregistré dans:
| Auteurs principaux: | , , , , , , |
|---|---|
| Format: | Preprint |
| Publié: |
2025
|
| Sujets: | |
| Accès en ligne: | |
| Tags: |
Ajouter un tag
Pas de tags, Soyez le premier à ajouter un tag!
|
| _version_ | 1866913828885757952 |
|---|---|
| author | Zhang, Weijie Hong, Xue Zhu, Ya-Nan Lin, Yuting Gan, Gregory Chen, Ronald C Gao, Hao |
| author_facet | Zhang, Weijie Hong, Xue Zhu, Ya-Nan Lin, Yuting Gan, Gregory Chen, Ronald C Gao, Hao |
| contents | Background: FLASH radiation therapy (FLASH-RT) uses ultra-high dose rates to induce the FLASH effect, enhancing normal tissue sparing. In proton Bragg peak FLASH-RT, this effect is confined to high-dose regions near the target at deep tissue levels. In contrast, Spatially Fractionated Radiation Therapy (SFRT) creates alternating high- and low-dose regions with high peak-to-valley dose ratios (PVDR), sparing tissues at shallow-to-intermediate depths. Purpose: This study investigates a novel proton modality (SFRT-FLASH) that synergizes FLASH-RT and SFRT to enhance normal tissue protection across all depths. Methods: Two SFRT techniques are integrated with FLASH-RT: proton GRID therapy (pGRID) with conventional beam sizes and proton minibeam radiation therapy (pMBRT) with submillimeter beams. These are implemented as pGRID-FLASH (SB-FLASH) and minibeam-FLASH (MB-FLASH), respectively. The pGRID technique uses a scissor-beam (SB) method to achieve uniform target coverage. To meet FLASH dose (5 Gy) and dose-rate (40 Gy/s) thresholds, a single-field uniform-dose-per-fraction strategy is used. Dose and dose-rate constraints are jointly optimized, including a CTV1cm structure (a 1 cm ring around the CTV) for each field. Results: Across four clinical cases, MB-FLASH and SB-FLASH plans were benchmarked against conventional (CONV), FLASH-RT (FLASH), pMBRT (MB), and pGRID (SB) plans. SFRT-FLASH achieved high FLASH effect coverage (~60-80% in CTV1cm) while preserving PVDR (~2.5-7) at shallow-to-intermediate depths. Conclusions: We present a proton treatment planning approach that combines the FLASH effect at depth with high PVDR near the surface, enhancing normal tissue protection and advancing proton therapy. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2505_06223 |
| institution | arXiv |
| publishDate | 2025 |
| record_format | arxiv |
| spellingShingle | A Proton Treatment Planning Method for Combining FLASH and Spatially Fractionated Radiation Therapy to Enhance Normal Tissue Protection Zhang, Weijie Hong, Xue Zhu, Ya-Nan Lin, Yuting Gan, Gregory Chen, Ronald C Gao, Hao Medical Physics Background: FLASH radiation therapy (FLASH-RT) uses ultra-high dose rates to induce the FLASH effect, enhancing normal tissue sparing. In proton Bragg peak FLASH-RT, this effect is confined to high-dose regions near the target at deep tissue levels. In contrast, Spatially Fractionated Radiation Therapy (SFRT) creates alternating high- and low-dose regions with high peak-to-valley dose ratios (PVDR), sparing tissues at shallow-to-intermediate depths. Purpose: This study investigates a novel proton modality (SFRT-FLASH) that synergizes FLASH-RT and SFRT to enhance normal tissue protection across all depths. Methods: Two SFRT techniques are integrated with FLASH-RT: proton GRID therapy (pGRID) with conventional beam sizes and proton minibeam radiation therapy (pMBRT) with submillimeter beams. These are implemented as pGRID-FLASH (SB-FLASH) and minibeam-FLASH (MB-FLASH), respectively. The pGRID technique uses a scissor-beam (SB) method to achieve uniform target coverage. To meet FLASH dose (5 Gy) and dose-rate (40 Gy/s) thresholds, a single-field uniform-dose-per-fraction strategy is used. Dose and dose-rate constraints are jointly optimized, including a CTV1cm structure (a 1 cm ring around the CTV) for each field. Results: Across four clinical cases, MB-FLASH and SB-FLASH plans were benchmarked against conventional (CONV), FLASH-RT (FLASH), pMBRT (MB), and pGRID (SB) plans. SFRT-FLASH achieved high FLASH effect coverage (~60-80% in CTV1cm) while preserving PVDR (~2.5-7) at shallow-to-intermediate depths. Conclusions: We present a proton treatment planning approach that combines the FLASH effect at depth with high PVDR near the surface, enhancing normal tissue protection and advancing proton therapy. |
| title | A Proton Treatment Planning Method for Combining FLASH and Spatially Fractionated Radiation Therapy to Enhance Normal Tissue Protection |
| topic | Medical Physics |
| url | https://arxiv.org/abs/2505.06223 |