Early experience with intensity modulated proton therapy for lung-intact mesothelioma: A case series

Hubert Y. Pan, Shengpeng Jiang, Jordan Sutton, Zhongxing Liao, William W. Chance, Steven J. Frank, X. Ronald Zhu, Heng Li, Hiral P. Fontanilla, Xiaodong Zhang, Daniel R. Gomez

Research output: Contribution to journalArticle

Abstract

Purpose: The purpose of this study was to describe our experience implementing intensity modulated proton therapy (IMPT) for lung-intact malignant pleural mesothelioma (MPM), including patient selection, treatment planning, dose verification, and process optimization. Methods and materials: Seven patients with epithelioid MPM were reviewed; 6 underwent pleurectomy, whereas 1 had biopsy alone. Four patients received IMPT and 3 received intensity modulated radiation therapy. Treatment plans for the other modality were created for dosimetric comparisons. Quality assurance processes included dose verification and robustness analysis. Image-guided setup was performed with the first isocenter, and couch shifts were applied to reposition to the second isocenter. Results: Treatment with IMPT was well tolerated and completed without breaks. IMPT plans were designed with 2 isocenters, 4 beams, and ≤. 64 energy layers per beam. Dose verification processes were completed in 3 hours. Total daily treatment time was approximately 45 minutes (20 minutes for setup and 25 minutes for delivery). IMPT produced lower mean doses to the contralateral lung, heart, esophagus, liver, and ipsilateral kidney, with increased contralateral lung sparing when mediastinal boost was required for nodal disease. Conclusions: Our initial experience showed that IMPT was feasible for routine care of patients with lung-intact MPM.

Original languageEnglish (US)
Pages (from-to)e345-e353
JournalPractical Radiation Oncology
Volume5
Issue number4
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Proton Therapy
Mesothelioma
Lung
Therapeutics
Patient Selection
Esophagus
Patient Care
Radiotherapy
Kidney
Biopsy
Liver
Malignant Mesothelioma

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Pan, H. Y., Jiang, S., Sutton, J., Liao, Z., Chance, W. W., Frank, S. J., ... Gomez, D. R. (2015). Early experience with intensity modulated proton therapy for lung-intact mesothelioma: A case series. Practical Radiation Oncology, 5(4), e345-e353. https://doi.org/10.1016/j.prro.2014.11.005

Early experience with intensity modulated proton therapy for lung-intact mesothelioma : A case series. / Pan, Hubert Y.; Jiang, Shengpeng; Sutton, Jordan; Liao, Zhongxing; Chance, William W.; Frank, Steven J.; Zhu, X. Ronald; Li, Heng; Fontanilla, Hiral P.; Zhang, Xiaodong; Gomez, Daniel R.

In: Practical Radiation Oncology, Vol. 5, No. 4, 01.01.2015, p. e345-e353.

Research output: Contribution to journalArticle

Pan, HY, Jiang, S, Sutton, J, Liao, Z, Chance, WW, Frank, SJ, Zhu, XR, Li, H, Fontanilla, HP, Zhang, X & Gomez, DR 2015, 'Early experience with intensity modulated proton therapy for lung-intact mesothelioma: A case series', Practical Radiation Oncology, vol. 5, no. 4, pp. e345-e353. https://doi.org/10.1016/j.prro.2014.11.005
Pan, Hubert Y. ; Jiang, Shengpeng ; Sutton, Jordan ; Liao, Zhongxing ; Chance, William W. ; Frank, Steven J. ; Zhu, X. Ronald ; Li, Heng ; Fontanilla, Hiral P. ; Zhang, Xiaodong ; Gomez, Daniel R. / Early experience with intensity modulated proton therapy for lung-intact mesothelioma : A case series. In: Practical Radiation Oncology. 2015 ; Vol. 5, No. 4. pp. e345-e353.
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