SU‐E‐T‐314: Dosimetric Effect of Smooth Drilling On Proton Compensators in Prostate Patients

Purpose: To evaluate the dosimetric effect of smooth drilling of proton compensators in proton prostate plans when compared to typical plunge drilling settings. Methods: Twelve prostate patients were planned in Eclipse treatment planning system using three different drill settings Smooth, Plunge drill A, and Plunge drill B. The differences between A and B were: spacing X[cm]: 0.4(A), 0.1(B), spacing Y[cm]: 0.35(A), 0.1(B), row offset [cm]: 0.2(A), 0(B). Planning parameters were kept consistent between the different plans, which utilized two opposed lateral beams arrangement. Mean differences absolute dosimetry in OAR constraints are presented. Results: The smooth drilled compensator based plans yielded equivalent target coverage to the plans generated with drill settings A and B. Overall, the smooth compensators reduced dose to the majority of organs at risk compared to settings A and B. Constraints were reduced for the following OAR: Rectal V75 by 2.12 and 2.48%, V70 by 2.45 and 2.91%, V65 by 2.85 and 3.37%, V50 by 2.3 and 5.1%, Bladder V65 by 4.49 and 3.67%, Penial Bulb mean by 3.7 and 4.2Gy, and the maximum plan dose 5.3 and 7.4Gy for option A vs smooth and option B vs smooth respectively. The femoral head constraint (V50<5%) was met by all plans, but it was not consistently lower for the smooth drilling plan. Conclusion: Smooth drilled compensators provide equivalent target coverage and overall slightly cooler plans to the majority of organs at risk; it also minimizes the potential dosimetric impacts caused by patient positioning uncertainty.