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@ARTICLE{Haefner:125945,
      author       = {M. F. Haefner and F. Sterzing and D. Krug and S. A. Koerber
                      and O. Jäkel$^*$ and J. Debus and M. M. Haertig},
      title        = {{I}ntrafractional dose variation and beam configuration in
                      carbon ion radiotherapy for esophageal cancer.},
      journal      = {Radiation oncology},
      volume       = {11},
      number       = {1},
      issn         = {1748-717X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2017-02069},
      pages        = {150},
      year         = {2016},
      abstract     = {In carbon ion radiotherapy (CIR) for esophageal cancer,
                      organ and target motion is a major challenge for treatment
                      planning due to potential range deviations. This study
                      intends to analyze the impact of intrafractional variations
                      on dosimetric parameters and to identify favourable settings
                      for robust treatment plans.We contoured esophageal boost
                      volumes in different organ localizations for four patients
                      and calculated CIR-plans with 13 different beam geometries
                      on a free-breathing CT. Forward calculation of these plans
                      was performed on 4D-CT datasets representing seven different
                      phases of the breathing cycle. Plan quality was assessed for
                      each patient and beam configuration.Target volume coverage
                      was adequate for all settings in the baseline CIR-plans
                      $(V95 > 98\%$ for two-beam geometries, $> 94\%$ for
                      one-beam geometries), but reduced on 4D-CT plans (V95 range
                      $50-95\%).$ Sparing of the organs at risk (OAR) was
                      adequate, but range deviations during the breathing cycle
                      partly caused critical, maximum doses to spinal cord up to
                      3.5x higher than expected. There was at least one beam
                      configuration for each patient with appropriate plan
                      quality.Despite intrafractional motion, CIR for esophageal
                      cancer is possible with robust treatment plans when an
                      individually optimized beam setup is selected depending on
                      tumor size and localization.},
      cin          = {E040},
      ddc          = {610},
      cid          = {I:(DE-He78)E040-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:27846916},
      pmc          = {pmc:PMC5109696},
      doi          = {10.1186/s13014-016-0727-2},
      url          = {https://inrepo02.dkfz.de/record/125945},
}