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At least 73 records · Page 4

Comparison of calculated dose distributions reported as dose-to-water and dose-to-medium for intensity-modulated radiotherapy of nasopharyngeal cancer patients

Advanced dose calculation algorithms for radiation therapy treatment planning can report external beam photon dose 2-sided, in terms of dose-to-medium (D{sub m}) and dose-to-water (D{sub w}). The purpose of our study was to determinate the effect of D{sub w} and D{sub m} reporting modes built in Elekta Monaco treatment planning system on intensity-modulated radiotherapy dose distributions for patients with nasopharyngeal cancer. For 13 patients involved in this retrospective study, 2 plans were created: 1 using D{sub w} and another according to D{sub m} reporting mode. Treatment plans were normalized such that 100% planning target volume should be covered by 95% of prescribed dose. Dose-volume constraints were assigned according to international standards. The comparison between dose distributions was performed evaluating quantities important for respective volumes of interest. For target volumes, heterogeneity index and conformity index methodology were used along with the maximum dose concept. Also, for the comparisons over particular organ at risk, maximum dose or mean dose as well as dose-volume concepts were used. For all target volumes and majority of organs at risk, the differences between 2 reporting modes are statistically insignificant, but this is not the case for bony structured organs at risks: mandible and cochlea. It was observed that D{sub w} is higher than D{sub m} with mean difference of 9.91% (p = 0.000009) of the mandible volume covered with 70 Gy. The same trend was observed for left and right cochlea with difference in mean dose of 8.74% (p = 0.037) and 6.87% (p = 0.029), respectively. The comparative analysis of dosimetric parameters in this study shows that the selection of reporting modes in Monaco treatment planning system can produce dose differences up to 15% in high-density volumes such as mandible and cochlea, which might have clinical consequences.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Electric Propulsion Upper-Stage for Launch Vehicle Capability Enhancement

The NASA In-Space Propulsion Technology Project Office initiated a preliminary study to evaluate the performance benefits of a solar electric propulsion (SEP) upper-stage with existing and near-term small launch vehicles. The analysis included circular and elliptical Low Earth Orbit (LEO) to Geosynchronous Earth Orbit (GEO) transfers, and LEO to Low Lunar Orbit (LLO) applications. SEP subsystem options included state-of-the-art and near-term solar arrays and electric thrusters. In-depth evaluations of the Aerojet BPT-4000 Hall thruster and NEXT gridded ion engine were conducted to compare performance, cost and revenue potential. Preliminary results indicate that Hall thruster technology is favored for low-cost, low power SEP stages, while gridded-ion engines are favored for higher power SEP systems unfettered by transfer time constraints. A low-cost point design is presented that details one possible stage configuration and outlines system limitations, in particular fairing volume constraints. The results demonstrate mission enhancements to large and medium class launch vehicles, and mission enabling performance when SEP system upper stages are mounted to low-cost launchers such as the Minotaur and Falcon 1. Study results indicate the potential use of SEP upper stages to double GEO payload mass capability and to possibly enable launch on demand capability for GEO assets. Transition from government to commercial applications, with associated cost/benefit analysis, has also been assessed. The sensitivity of system performance to specific impulse, array power, thruster size, and component costs are also discussed.

Kemp, Gregory E.↗

Instrumentation for the Characterization of Inflatable Structures

Current entry, descent, and landing technologies are not practical for heavy payloads due to mass and volume constraints dictated by limitations imposed by launch vehicle fairings. Therefore, new technologies are now being explored to provide a mass- and volume-efficient solution for heavy payload capabilities, including Inflatable Aerodynamic Decelerators (IAD) [1]. Consideration of IADs for space applications has prompted the development of instrumentation systems for integration with flexible structures to characterize system response to flight-like environment testing. This development opportunity faces many challenges specific to inflatable structures in extreme environments, including but not limited to physical flexibility, packaging, temperature, structural integration and data acquisition [2]. In the spring of 2012, two large scale Hypersonic Inflatable Aerodynamic Decelerators (HIAD) will be tested in the National Full-Scale Aerodynamics Complex s 40 by 80 wind tunnel at NASA Ames Research Center. The test series will characterize the performance of a 3.0 m and 6.0 m HIAD at various angles of attack and levels of inflation during flight-like loading. To analyze the performance of these inflatable test articles as they undergo aerodynamic loading, many instrumentation systems have been researched and developed. These systems will utilize new experimental sensing systems developed by the HIAD ground test campaign instrumentation team, in addition to traditional wind tunnel sensing techniques in an effort to improve test article characterization and model validation. During the 2012 test series the instrumentation systems will target inflatable aeroshell static and dynamic deformation, structural strap loading, surface pressure distribution, localized skin deflection, and torus inflation pressure. This paper will offer an overview of inflatable structure instrumentation, and provide detail into the design and implementation of the sensors systems that will be utilized during the 2012 HIAD ground test campaign.

Swanson, Gregory T.↗

OCCAMS: Optically Controlled and Corrected Active Meta-Material Space Structures

Telescopes require sub-wavelength figure (shape) error in order to achieve acceptable Strehl ratios. Traditional methods of achieving this require rigid and therefore heavy mirrors and reaction structures as well as proportionally heavy and expensive spacecraft busses and launch vehicles. This effectively limits the diameter and therefore resolution and collecting area of space optics. Large diameter telescopes must either be heavy or actively controlled. Space telescopes of the size proposed for missions such as TPF (Terrestrial Planet Finder), TPI (Terrestrial Planet Imager), etc. will likely require large active primaries and structures and corrective optics to implement downstream wavefront control. We propose a novel viable enabling technology. High resolution space imaging requires the production of lightweight large aperture optics subject to design tradespace constraints based on nanometer physical tolerances, low system aerial density, high control authority, suitable thermal and mechanical properties, deployment capability, launch vehicle volume constraints, as well as production cost and schedule risk mitigation. Segmented systems impose additional requirements on segment alignment, wavefront phasing, and telescope mass with increased edge diffraction. Photons weigh nothing. Why must even small space telescopes "weigh" tons? Our team is working to demonstrate that they do not, by leveraging 15 years of effort and a novel advanced concept.The ultimate research goal is to refine technology to produce a mission capable ultra-lightweight membrane optic whose shape can be remotely controlled using a laser beam. Using our novel optically-controlled molecular actuators allows substitution of optically-induced control for rigidity and mirror mass. In analogy with noise-canceling headphones, this technique also potentially provides a way to excite vibratory modes to couple with and damp out normal modes of oscillation induced by slewing, other motion and thermal changes, thus allowing a robust response to repointing of a large aperture.

Astronomy↗

Dosimetric evaluation of 4 different treatment modalities for curative-intent stereotactic body radiation therapy for isolated thoracic spinal metastases

To investigate the dosimetric characteristics of 4 SBRT-capable dose delivery systems, CyberKnife (CK), Helical TomoTherapy (HT), Volumetric Modulated Arc Therapy (VMAT) by Varian RapidArc (RA), and segmental step-and-shoot intensity-modulated radiation therapy (IMRT) by Elekta, on isolated thoracic spinal lesions. CK, HT, RA, and IMRT planning were performed simultaneously for 10 randomly selected patients with 6 body types and 6 body + pedicle types with isolated thoracic lesions. The prescription was set with curative intent and dose of either 33 Gy in 3 fractions (3F) or 40 Gy in 5F to cover at least 90% of the planning target volume (PTV), correspondingly. Different dosimetric indices, beam-on time, and monitor units (MUs) were evaluated to compare the advantages/disadvantages of each delivery modality. In ensuring the dose-volume constraints for cord and esophagus of the premise, CK, HT, and RA all achieved a sharp conformity index (CI) and a small penumbra volume compared to IMRT. RA achieved a CI comparable to those from CK, HT, and IMRT. CK had a heterogeneous dose distribution in the target as its radiosurgical nature with less dose uniformity inside the target. CK had the longest beam-on time and the largest MUs, followed by HT and RA. IMRT presented the shortest beam-on time and the least MUs delivery. For the body-type lesions, CK, HT, and RA satisfied the target coverage criterion in 6 cases, but the criterion was satisfied in only 3 (50%) cases with the IMRT technique. For the body + pedicle-type lesions, HT satisfied the criterion of the target coverage of ≥90% in 4 of the 6 cases, and reached a target coverage of 89.0% in another case. However, the criterion of the target coverage of ≥90% was reached in 2 cases by CK and RA, and only in 1 case by IMRT. For curative-intent SBRT of isolated thoracic spinal lesions, RA is the first choice for the body-type lesions owing to its delivery efficiency (time); the second choice is CK or HT; HT is the preferential choice for the body + pedicle-type lesions. This study suggests further clinical investigations with longer follow-up for these studied cases.

61 RADIATION PROTECTION AND DOSIMETRY↗

Pterodactyl: Control System Design for Deployable Entry Vehicles

As space exploration missions continue to get more complex, greater demands for mass and volume are being placed on planetary entry vehicles. At the same time, the desire for precision entry targeting to enable surface missions at very specific locations is becoming common. Deployable aeroshells are one type of technology that is being developed to increase the down-mass capability of planetary entry vehicles while complying with current launch vehicle volume constraints. Propulsive control can be used for precision entry targeting but can require a large percentage of the vehicle's total mass or volume for propellant. The Pterodactyl project is studying alternative entry control systems on a Deployable Entry Vehicle to potentially introduce a mass and volume efficient entry system that can achieve precision targeting. This paper presents the mechanical design work undertaken to support the Pterodactyl trade study of three entry vehicle control system options: 1) Flaps, 2) Mass Movement, and 3) Reaction Control System.

D'Souza, Sarah↗

The Challenges of Integrating Instrumentation with Inflatable Aerodynamic Decelerators

To realize the National Aeronautics and Space Administration s (NASA) goal of landing humans on Mars, development of technologies to facilitate the landing of heavy payloads are being explored. Current entry, decent, and landing technologies are not practical when utilizing these heavy payloads due to mass and volume constraints dictated by limitations imposed by current launch vehicle fairings. Therefore, past and present technologies are now being considered to provide a mass and volume efficient solution, including Inflatable Aerodynamic Decelerators (IADs) [1]. IAD ground and flight tests are currently being conducted to develop and characterize their performance under flight-like conditions. The integrated instrumentation systems, which are key to the performance characterization in each of these tests, have proven to be a challenge compared to the instrumentation of traditional rigid aeroshells. To overcome these challenges, flexible and embedded sensing systems have been developed, along with improved instrumenting techniques. This development opportunity faces many difficult aspects specific to inflatable structures in extreme environments. These include but are not limited to: physical flexibility, packaging, temperature, structural integration and data acquisition [2]. To better define the instrumentation challenges posed by IAD technology development, a survey was conducted to identify valuable measurements for ground and flight testing. From this survey many sensing technologies were explored, resulting in a down-selection to the most viable prospects. These systems were then iterated upon in design to determine the best integration techniques specific to a 3m and 6m stacked torus IAD. Each sensing system was then integrated and employed to support the IAD testing in the National Full-Scale Aerodynamics Complex 40 x 80 wind tunnel at NASA Ames Research Center in the summer of 2012. Another challenge that has been explored is the data acquisition of IAD sensing technologies. Traditionally all space based sensing systems transmit their data through a wired interface. This limits the amount of sensors able to be integrated within the IAD due to volume and routing restrictions of the supporting signal and excitation wires. To alleviate this situation, multiple wireless data acquisition technologies have been researched and developed through rapid prototyping efforts. The final custom multi-nodal wireless system utilized during the summer 2012 IAD test series consisted of four remote nodes and one receiving base station. The system reliably conditioned and acquired 20+ sensors over the course of the wind tunnel test series. These developments in wireless data acquisition techniques can eliminate the need for structural feedthroughs and reduce system mass associated with wiring and wire harnesses. This makes the utilization of flight instrumentation more attractive to future missions, which would result in further improved characterization of IAD technology, and overall, increased scientific knowledge regarding the response of inflatable structures to extreme entry environments. [

Swanson, Gregory T.↗

Integrated Vehicle and Trajectory Design of Small Spacecraft with Electric Propulsion for Earth and Interplanetary Missions

This paper investigates the feasibility of Earth-transfer and interplanetary mission architectures for miniaturized spacecraft using emerging small solar electric propulsion technologies. Emerging small SEP thrusters offer significant advantages relative to existing technologies and will enable U-class systems to perform trajectory maneuvers with significant Delta V requirements. The approach in this paper is unique because it integrates trajectory design with vehicle sizing and accounts for the system and operational constraints of small U-class missions. The modeling framework includes integrated propulsion, orbit, energy, and external environment dynamics and systems-level power, energy, mass, and volume constraints. The trajectory simulation environment models orbit boosts in Earth orbit and flyby and capture trajectories to interplanetary destinations. A family of small spacecraft mission architectures are studied, including altitude and inclination transfers in Earth orbit and trajectories that escape Earth orbit and travel to interplanetary destinations such as Mercury, Venus, and Mars. Results are presented visually to show the trade-offs between competing performance objectives such as maximizing available mass and volume for payloads and minimizing transfer time. The results demonstrate the feasibility of using small spacecraft to perform significant Earth and interplanetary orbit transfers in less than one year with reasonable U-class mass, power, volume, and mission durations.

Spangelo, Sara↗

Dosimetric Comparison of Manual and Beam Angle Optimization of Gantry Angles in IMRT

Dosimetric comparison of manual beam angle selection (MBS) and beam angle optimization (BAO) for IMRT plans is investigated retrospectively for 15 head and neck and prostate patients. The head and neck and prostate had planning target volumes (PTVs) ranging between 96.0 and 319.9 cm{sup 3} and 153.6 and 321.3 cm{sup 3}, whereas OAR ranged between 8.3 and 47.8 cm{sup 3} and 68.3 and 469.2 cm{sup 3}, respectively. In MBS, a standard coplanar 7-9 fields equally spaced gantry angles were used. In BAO, the selection of gantry angle was optimized by the algorithm for the same number of beams. The optimization and dose-volume constraints were kept the same for both techniques. Treatment planning was performed on the Eclipse treatment planning system. Our results showed that the dose-volume histogram for PTV are nearly identical in both techniques but BAO provided superior sparing of the organs at risk compared with the MBS. Also, MBS produced statistically significant higher monitor units (MU) and segments than the BAO; 13.1 {+-} 6.6% (p = 0.012) and 10.4 {+-} 13.6% (p = 0.140), and 14.6 {+-} 5.6% (p = 1.003E-5) and 12.6 {+-} 7.4% (p = 0.76E-3) for head and neck and prostate cases, respectively. The reduction in MU translates into the reduction in total body and integral dose. It is concluded that BAO provides advantage over MBS for most intenisty-modulated radiation therapy cases.

61 RADIATION PROTECTION AND DOSIMETRY↗

Impact Outputs for A Representative Extended Duration Artemis Mission

BACKGROUND: As NASA and private industry begin preparation for long-duration spaceflight, quantifying the impact that potential human health and performance capabilities have on crew health outcomes is imperative for medical risk mitigation. NASA’s Informing Mission Planning via Analysis of Complex Tradespaces tool (IMPACT) applies Probabilistic Risk Assessment (PRA) methodology to estimate these outcomes. OVERVIEW: As NASA prepares to return to the Moon, medical system planning has already begun for extended Artemis missions, which will see humans spending months at a time in cis-lunar space and on the surface of the Moon. The Long Duration Lunar Orbital and Lunar Surface (LDLOLS) design reference mission (DRM) lasts 9 months, including 3 months on the lunar surface, and involves 2 male and 2 female crewmembers. LDLOLS assumes no extravehicular activities (EVAs) in orbit, but, while on the lunar surface, involves 2-4 EVAs/month in a pressurized rover and 2-4 EVAs/month in an unpressurized rover or on foot. This DRM assumes a physician level Crew Medical Officer with commensurate knowledge, skills, and abilities. The IMPACT tool was utilized to estimate in-flight medical risk for this mission. More specifically, 100,000 simulations of this DRM were modeled, and overall estimates for loss of crew life (LOCL), need for evacuation (RTDC; return to definitive care), and crew task time lost (TTL; a measure of disability) were calculated. A recommended medical capability set, with appropriate mass and volume constraints, was also generated. DISCUSSION: This abstract reviews the IMPACT-derived risk for these mission outcomes with and without treatment, a macroscopic look at the total mass and volume necessary for full diagnostic and treatment capability, and how these change with input mission parameters.

J G Steller↗

SU-E-T-428: Dosimetric Impact of Multileaf Collimator Leaf Width On Single and multiple Isocenter Stereotactic IMRT Treatment Plans for multiple Brain Tumors

Purpose: To assess the impacts that multileaf collimator (MLC) leaf width has on the dose conformity and normal brain tissue doses of single and multiple isocenter stereotactic IMRT (SRT) plans for multiple intracranial tumors. Methods: Fourteen patients with 2–3 targets were studied retrospectively. Patients treated with multiple isocenter treatment plans using 9 to 12 non-coplanar beams per lesion underwent repeat planning using single isocenter and 10 to 12 non-coplanar beams with 2.5mm, 3mm and 5mm MLC leaf widths. Brainlab iPlan treatment planning system for delivery with the 2.5mm MLC served as reference. Identical contour sets and dose-volume constraints were applied. The prescribed dose to each target was 25 Gy to be delivered over 5 fractions with a minimum of 99% dose to cover ≥ 95% of the target volume. Results: The lesions and normal brains ranged in size from 0.11 to 51.67cc (median, 2.75cc) and 1090 to 1641cc (median, 1401cc), respectively. The Paddick conformity index for single and multiple isocenter (2.5mm vs. 3mm and 5mm MLCs) was (0.79±0.08 vs. 0.79±0.07 and 0.77±0.08) and (0.79±0.09 vs. 0.77±0.09 and 0.76±0.08), respectively. The average normal brain volumes receiving 15 Gy for single and multiple isocenter (2.5mm vs. 3mm and 5mm MLCs) were (3.65% vs. 3.95% and 4.09%) and (2.89% vs. 2.91% and 2.92%), respectively. Conclusion: The average dose conformity observed for the different leaf width for single and multiple isocenter plans were similar, throughout. However, the average normal brain volumes receiving 2.5 to 15 Gy were consistently lower for the 2.5mm MLC leaf width, especially for single isocenter plans. The clinical consequences of these integral normal brain tissue doses are still unknown, but employing the use of the 2.5mm MLC option is desirable at sparing normal brain tissue for both single and multiple isocenter cases.

60 APPLIED LIFE SCIENCES↗

GUIDING NONLINEAR FORCE-FREE MODELING USING CORONAL OBSERVATIONS: FIRST RESULTS USING A QUASI-GRAD-RUBIN SCHEME

At present, many models of the coronal magnetic field rely on photospheric vector magnetograms, but these data have been shown to be problematic as the sole boundary information for nonlinear force-free field extrapolations. Magnetic fields in the corona manifest themselves in high-energy images (X-rays and EUV) in the shapes of coronal loops, providing an additional constraint that is not at present used as constraints in the computational domain, directly influencing the evolution of the model. This is in part due to the mathematical complications of incorporating such input into numerical models. Projection effects, confusion due to overlapping loops (the coronal plasma is optically thin), and the limited number of usable loops further complicate the use of information from coronal images. We develop and test a new algorithm to use images of coronal loops in the modeling of the solar coronal magnetic field. We first fit projected field lines with those of constant-{alpha} force-free fields to approximate the three-dimensional distribution of currents in the corona along a sparse set of trajectories. We then apply a Grad-Rubin-like iterative technique, which uses these trajectories as volume constraints on the values of {alpha}, to obtain a volume-filling nonlinear force-free model of the magnetic field, modifying a code and method presented by Wheatland. We thoroughly test the technique on known analytical and solar-like model magnetic fields previously used for comparing different extrapolation techniques and compare the results with those obtained by currently available methods relying only on the photospheric data. We conclude that we have developed a functioning method of modeling the coronal magnetic field by combining the line-of-sight component of the photospheric magnetic field with information from coronal images. Whereas we focus on the use of coronal loop information in combination with line-of-sight magnetograms, the method is readily extended to incorporate vector-magnetic data over any part of the photospheric boundary.

79 ASTRONOMY AND ASTROPHYSICS↗

In-flight demonstration of the Space Station Freedom Health Maintenance Facility fluid therapy system (E300/E05)

The Space Station Freedom (SSF) Health Maintenance Facility (HMF) will provide medical care for crew members for up to 10 days. An integral part of the required medical care consists of providing intravenous infusion of fluids, electrolyte solutions, and nutrients to sustain an ill or injured crew member. In terrestrial health care facilities, intravenous solutions are normally stored in large quantities. However, due to the station's weight and volume constraints, an adequate supply of the required solutions cannot be carried onboard SSF. By formulating medical fluids onboard from concentrates and station water as needed, the Fluid Therapy System (FTS) eliminates weight and volume concerns regarding intravenous fluids. The first full-system demonstration of FTS is continuous microgravity will be conducted in Spacelab-Japan (SL-J). The FTS evaluation consists of two functional objectives and an in-flight demonstration of intravenous administration of fluids. The first is to make and store sterile water and IV solutions onboard the spacecraft. If intravenous fluids are to be produced in SSF, successful sterilization of water and reconstituting of IV solutions must be achieved. The second objective is to repeat the verification of the FTS infusion pump, which had been performed in Spacelab Life Sciences - 1 (SLS-1). during SLS-1, the FTS IV pump was operated in continuous microgravity for the first time. The pump functioned successfully, and valuable knowledge on its performance in continuous microgravity was obtained. Finally, the technique of starting an IF in microgravity will be demonstrated. The IV technique requires modifications in microgravity, such as use of restraints for equipment and crew members involved.

Lloyd, Charles W.↗

SU-F-T-388: Comparison of Biophysical Indices in Hippocampal-Avoidance Whole Brain VMAT and IMRT Radiation Therapy Treatment Plans

Purpose: To compare biophysical indices of Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiation Therapy (IMRT) treatment plans for whole brain radiation therapy following the NRG-CC001 protocol. Methods: In this retrospective study, a total of fifteen patients were planned with Varian Eclipse Treatment Planning System using VMAT (RapidArc) and IMRT techniques. The planning target volume (PTV) was defined as the whole brain volume excluding a uniform three-dimensional 5mm expansion of the hippocampus volume. Prescribed doses in all plans were 30 Gy delivered over 10 fractions normalized to a minimum of 95% of the target volume receiving 100% of the prescribed dose. The NRG Oncology protocol guidelines were followed for contouring and dose-volume constraints. A single radiation oncologist evaluated all treatment plans. Calculations of statistical significance were performed using Student’s paired t-test. Results: All VMAT and IMRT plans met the NRG-CC001 protocol dose-volume criteria. The average equivalent uniform dose (EUD) for the PTV for VMAT vs. IMRT was respectively (19.05±0.33 Gy vs. 19.38±0.47 Gy) for α/β of 2 Gy and (19.47±0.30 Gy vs. 19.84±0.42 Gy) for α/β of 10 Gy. For the PTV, the average mean and maximum doses were 2% and 5% lower in VMAT plans than in IMRT plans, respectively. The average EUD and the normal tissue complication probability (NTCP) for the hippocampus in VMAT vs. IMRT plans were (15.28±1.35 Gy vs. 15.65±0.99 Gy, p=0.18) and (0.305±0.012 Gy vs. 0.308±0.008 Gy, p=0.192), respectively. The average EUD and NTCP for the optic chiasm were both 2% higher in VMAT than in IMRT plans. Conclusion: Though statistically insignificant, VMAT plans indicate a lower hippocampus EUD than IMRT plans. Also, a small variation in NTCP was found between plans.

60 APPLIED LIFE SCIENCES↗

IVGen Mini Techport May 2024

Intravenous (IV) fluids are an important treatment modality for multiple medical conditions that have the potential to occur during Mars missions and that may lead to adverse crew health and mission outcomes without appropriate treatment. However, carrying sufficient volumes of IV fluids with adequate shelf life to support such missions is currently not feasible due to anticipated mass and volume constraints of future vehicles and the relatively short shelf-life of terrestrial IV fluids. The goal of the IntraVenous Fluid Generation for Exploration Missions, Miniaturized, (IVGen Mini) project is to develop a low mass and volume IV fluid generation device that can produce IV fluids in situ and that reduces the need to launch and store large quantities of IV fluids. It builds on the original IVGEN system developed by the Human Research Program’s Exploration Medical Capability Element that successfully demonstrated the capability to produce in-situ IV fluids aboard the ISS in 2010 using an ISS potable water source. Flight demonstration objectives for this system included purification via packed bed resin, bubble removal, sterilization, passive mixing in microgravity, and United States Pharmacopeia (USP) tested compliance. The project will culminate in a flight technical demonstration on the ISS in 2025/2026.

Courtney M Schkurko↗

Correlation of dosimetric parameters obtained with the analytical anisotropic algorithm and toxicity of chest chemoradiation in lung carcinoma

The purpose of this study was to analyze and revisit toxicity related to chest chemoradiotherapy and to correlate these side effects with dosimetric parameters obtained using analytical anisotropic algorithm (AAA) in locally unresectable advanced lung cancer. We retrospectively analyzed data from 47 lung cancer patients between 2005 and 2008. All received conformal 3D radiotherapy using high-energy linear accelerator plus concomitant chemotherapy. All treatment planning data were transferred into Eclipse 8.05 (Varian Medical Systems, Palo Alto, CA) and dosimetric calculations were performed using AAA. Thirty-three patients (70.2%) developed acute pneumopathy after radiotherapy (grades 1 and 2). One patient (2.1%) presented with grade 3 pneumopathy. Thirty-one (66%) presented with grades 1-2 lung fibrosis, and 1 patient presented with grade 3 lung fibrosis. Thirty-four patients (72.3%) developed grade 1-2 acute oesophagic toxicity. Four patients (8.5%) presented with grades 3 and 4 dysphagia, necessitating prolonged parenteral nutrition. Median prescribed dose was 64 Gy (range 50-74) with conventional fractionation (2 Gy per fraction). Dose-volume constraints were respected with a median V20 of 23.5% (maximum 34%) and a median V30 of 17% (maximum 25%). The median dose delivered to healthy contralateral lung was 13.1 Gy (maximum 18.1 Gy). At univariate analysis, larger planning target volume and V20 were significantly associated with the probability of grade {>=}2 radiation-induced pneumopathy (p = 0.022 and p = 0.017, respectively). No relation between oesophagic toxicity and clinical/dosimetric parameters could be established. Using AAA, the present results confirm the predictive value of the V20 for lung toxicity as already demonstrated with the conventional pencil beam convolution approach.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-E-T-357: Semi-Automated Knowledge-Based Radiation Therapy (KBRT) Planning for Head-And-Neck Cancer (HNC): Can KBRT Plans Achieve Better Results Than Manual Planning?

Purpose: Knowledge Based Radiation Therapy Treatment (KBRT) planning can be used to semi-automatically generate IMRT plans for new patients using constraints derived from previously manually-planned, geometrically similar patients. We investigate whether KBRT plans can achieve greater dose sparing than manual plans using optimized, organspecific constraint weighting factors. Methods: KBRT planning of HNC radiotherapy cases geometrically matched each new (query) case to one of the 105 clinically approved plans in our database. The dose distribution of the planned match was morphed to fit the querys geometry. Dose-volume constraints extracted from the morphed dose distribution were used to run the IMRT optimization with no user input. In the first version, all constraints were multiplied by a weighting factor of 0.7. The weighting factors were then systematically optimized (in order of OARs with increasing separation from the target) to maximize sparing to each OAR without compromising other OARs. The optimized, second version plans were compared against the first version plans and the clinically approved plans for 45 unilateral/bilateral target cases using the dose metrics: mean, median and maximum (brainstem and cord) doses. Results: Compared to the first version, the second version significantly reduced mean/median contralateral parotid doses (>2Gy) for bilateral cases. Other changes between the two versions were not clinically meaningful. Compared to the original clinical plans, both bilateral and unilateral plans in the second version had lower average dose metrics for 5 of the 6 OARs. Compared to the original plans, the second version achieved dose sparing that was at least as good for all OARs and better for the ipsilateral parotid (bilateral) and oral cavity (bilateral/unilateral). Differences in planning target volume coverage metrics were not clinically significant. Conclusion: HNC-KBRT planning generated IMRT plans with at least equivalent dose sparing to manually generated plans; greater dose sparing was achieved in selected OARs.

60 APPLIED LIFE SCIENCES↗

TU-H-CAMPUS-TeP1-01: Variable-Beam Fractionation for SAbR

Purpose: In current conventionally-fractionated as well as hypofractionated 3D conformal radiotherapy (CRT), the same beam arrangement is employed from fraction to fraction. We challenge this notion and postulate that by varying the beam arrangement between fractions we can achieve greater sparing of organs at risk (OARs) while maintaining PTV coverage. We use an inverse planning strategy using a swarm intelligence-based global optimization algorithm to exploit the additional degree of freedom represented by inter-fractional variation in beam angles. Methods: To evaluate our variable-beam fractionation (VBF) method, a 10-beam ITV-based conformal stereotactic ablative radiotherapy (CRT-SAbR) plan was optimized. In the clinical plan, 54 Gy was delivered to a 41cc lung tumor over 3 fractions. In VBF, each original clinically-assigned beam was multiplied to a bundle of n α-degree-spaced beams, n being number of fractions. Selection of α was a compromise between retaining similar tumor irradiation and separating inline OAR sub-regions. We optimized the beam fluence weights setting an upper limit for beam delivery duration (and implicitly, monitor units) along with clinical organ-based dose-volume constraints. Zero weights were allowed so that the optimization algorithm could remove unnecessary beams. All fractions in final plan had to deliver identical monitor units (MU) while satisfying a soft constraint on having no more than one beam from every n-beam bundle in each fraction. α was 10 degrees and the dose rate was 600 MU/min. Results: The VBF plan achieved significantly superior OAR sparing compared to the clinical internal target volume (ITV)-based plan. Setting maximum beam delivery duration to 13 seconds (well within breath-hold range), Esophagus Dmax, Heart Dmax, Spinal cord Dmax and Lung V13 were improved by 25%, 81%, 0% and 27%, respectively. Conclusion: We investigated a simple approach to inter-fractional VBF planning and demonstrated its potential in reducing dose to OARs. This work was partially supported through research funding from National Institutes of Health (R01CA169102) and Varian Medical Systems, Palo Alto, CA, USA.

60 APPLIED LIFE SCIENCES↗