%0 Journal Article
%A Steitz, Julian
%A Naumann, Patrick
%A Ulrich, Silke
%A Haefner, Matthias F
%A Sterzing, Florian
%A Oelfke, Uwe
%A Bangert, Mark
%T Worst case optimization for interfractional motion mitigation in carbon ion therapy of pancreatic cancer.
%J Radiation oncology
%V 11
%N 1
%@ 1748-717X
%C London
%I BioMed Central
%M DKFZ-2017-05679
%P 134
%D 2016
%X The efficacy of radiation therapy treatments for pancreatic cancer is compromised by abdominal motion which limits the spatial accuracy for dose delivery - especially for particles. In this work we investigate the potential of worst case optimization for interfractional offline motion mitigation in carbon ion treatments of pancreatic cancer.We implement a worst case optimization algorithm that explicitly models the relative biological effectiveness of carbon ions during inverse planning. We perform a comparative treatment planning study for seven pancreatic cancer patients. Treatment plans that have been generated using worst case optimization are compared against (1) conventional intensity-modulated carbon ion therapy, (2) single field uniform dose carbon ion therapy, and (3) an ideal yet impractical scenario relying on daily re-planning. The dosimetric quality and robustness of the resulting treatment plans is evaluated using reconstructions of the daily delivered dose distributions on fractional control CTs.Idealized daily re-planning consistently gives the best dosimetric results with regard to both target coverage and organ at risk sparing. The absolute reduction of D 95 within the gross tumor volume during fractional dose reconstruction is most pronounced for conventional intensity-modulated carbon ion therapy. Single field uniform dose optimization exhibits no substantial reduction for six of seven patients and values for D 95 for worst case optimization fall in between. The treated volume (D>95 
%K Ions (NLM Chemicals)
%K Carbon (NLM Chemicals)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:27717378
%2 pmc:PMC5055683
%R 10.1186/s13014-016-0705-8
%U https://inrepo02.dkfz.de/record/130601