TY  - JOUR
AU  - Steitz, Julian
AU  - Naumann, Patrick
AU  - Ulrich, Silke
AU  - Haefner, Matthias F
AU  - Sterzing, Florian
AU  - Oelfke, Uwe
AU  - Bangert, Mark
TI  - Worst case optimization for interfractional motion mitigation in carbon ion therapy of pancreatic cancer.
JO  - Radiation oncology
VL  - 11
IS  - 1
SN  - 1748-717X
CY  - London
PB  - BioMed Central
M1  - DKFZ-2017-05679
SP  - 134
PY  - 2016
AB  - 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 
KW  - Ions (NLM Chemicals)
KW  - Carbon (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:27717378
C2  - pmc:PMC5055683
DO  - DOI:10.1186/s13014-016-0705-8
UR  - https://inrepo02.dkfz.de/record/130601
ER  -