SU‐E‐T‐683: Robustness Analysis of Multiple Filed Optimized IMPT Plans for Head & Neck Patients Treated at MD Anderson Cancer Center

Abstract

Purpose:Our center's clinical outcome data so far indicated that excellent local control for the head and neck patients treated using multiple field optimized (MFO) IMPT technique have been achieved. The purpose is to determine the robustness of those IMPT plans and provide the clinician the knowledge of the degree of the robustness which will not compromise the local control and is safe for the normal tissue.Methods:A fast and approximate dose calculation method is developed to calculate the dose for the IMPT plan under different setup and range uncertainties. The dosimetric index evaluated using this method are compared with those calculated using the dose calculation model in TPS. A worst case scenario robustness analysis method is implemented using the fast dose calculation method. 100 head neck plans treated using MFO IMPT were retrospectively analyzed using implemented robustness analysis method. The lowest dose received by 95% target (D95) and the highest dose received by 5% target (D5) of GTV, CTV1, CTV2, CTV3, mean dose of parotid glands, cochlea and brain and the minimum dose in the most radiated 1 cm3 volume (D1cc) of spinal cord and brain stem were compared between nominal plans and plans in the worst case scenario.Results:For GTV, CTV1 CTV2 and CTV3, D95 in worst scenario are lower by 2.08, 4.59, 5.25 and 5.46 Gy than nominal plan, while D5 are higher by 1.14, 0.98, 0.85 and 1.21 Gy. D1cc of brain stem and spinal in worst scenario are higher by 3.37 and 1.95 Gy than nominal plan. The mean dose of parotid glands, cochlea and brain are higher by 3.52, 3.69 and 0.64 Gy respectively.Conclusion:The robustness analysis data from the clinically treated patients enables the clinician to gauge the degree of robustness in their clinical practice when adopting MFO IMPT technique for patient treatment.