SU-G-BRA-15: Dosimetric Evaluation of Dynamic Tumor Tracking Radiation Therapy Using Digital Phantom: A Study On Margin and Desired Accuracy of Tracking.

PURPOSE: Dynamic tumor tracking radiation therapy can potentially reduce internal margin without prolongation of irradiation time. However, dynamic tumor tracking technique requires an extra margin (tracking margin, TM) for the uncertainty of tumor localization, prediction, and beam repositioning. The purpose of this study was to evaluate a dosimetric impact caused by TM.

METHODS: We used 4D XCAT to create 9 digital phantom datasets of different tumor size and motion range: tumor diameter TD={1, 3, 5} cm and motion range MR={1, 2, 3} cm. For each dataset, respiratory gating (30%-70% phase) and tumor tracking treatment plans were created using 8-field 3D-CRT by 4D dose calculation implemented in RayStation. The dose constraint was based on RTOG0618. For the tracking plan, TMs of {0, 2.5, 5} mm were considered by surrounding a normal setup margin: SM=5 mm. We calculated V20 of normal lung to evaluate the dosimetric impact for each case, and estimated an equivalent TM that affects the same impact on V20 obtained by the gated plan.

RESULTS: The equivalent TMs for {TD=1 cm, MR=2 cm}, {TD=1 cm, MR=3 cm}, {TD=5 cm, MR=2 cm}, and {TD=5 cm, MR=3 cm} were estimated as 1.47 mm, 3.95 mm, 1.04 mm, and 2.13 mm, respectively. The larger the tumor size, the equivalent TM became smaller. On the other hand, the larger the motion range, the equivalent TM was found to be increased.

CONCLUSION: Our results showed the equivalent TM changes depending on tumor size and motion range. The tracking plan with TM less than the equivalent TM achieves a dosimetric impact better than the gated plan in less treatment time. This study was partially supported by JSPS Kakenhi and Varian Medical Systems.