In silico study of LET-optimized multi-ION therapy for bone and soft tissue sarcomas
Abstract
Background and aims Charged-particle radiotherapy with ions heavier than protons is effective for the treatment of radiation-resistant hypoxic tumor due to high linear energy transfer (LET). Patients with unresectable bone and soft tissue sarcoma have been treated with carbon-ion radiotherapy at National Institute for Quantum Science and Technology. Multi-ion radiotherapy with carbon, oxygen and neon ions aims to improve treatment results by increasing LET in the target. We conducted in silico study of LET optimization toward the first clinical trial for multi-ion radiotherapy for bone and soft tissue sarcomas. Methods A numerical phantom of the patient with a gross tumor volume (GTV) and a planning target volume (PTV) was simulated using in-house treatment planning software. PTVs of three different sizes (500, 1000, and 1500 ml) mimicking bone and soft tissue sarcoma tumors were placed at the center of the phantom and 80 mm horizontally shifted from the center. GTVs were defined as the volume 1 cm inside the PTVs. The multi-ion treatment plans were made for the targets with two orthogonal scanning beams of carbon and oxygen or carbon and neon ions. For comparison, treatment plans with only carbon ions (carbon-only plans) were made for the same targets. In all treatment plans, the dose-averaged LET (LETd) distribution was optimized to increase the minimum LETd (LETdmin) in the GTV. The dose distributions and the LETdmin values in the target for multi-ion treatment plans were…
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