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Updated: May 15, 2026

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Treatment planning optimisation in proton therapy.

S E McGowan1, N G Burnet, A J Lomax

  • 1Department of Oncology, University of Cambridge, Cambridge, UK. sem89@cam.ac.uk

The British Journal of Radiology
|December 21, 2012
PubMed
Summary

Proton therapy requires precise range accuracy due to the finite range of protons. This review details geometric uncertainties and their impact on proton dose plans, highlighting methods for robust treatment planning.

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Area of Science:

  • Medical Physics
  • Radiation Oncology

Background:

  • Radiotherapy aims for uniform target coverage and normal tissue sparing.
  • Proton therapy shares geometric uncertainties with conventional radiotherapy but has a finite proton range dependent on material electron density.
  • This finite range creates a steep dose gradient at the Bragg peak's distal edge.

Purpose of the Study:

  • To review current knowledge of geometric uncertainties in proton therapy.
  • To discuss the impact of these uncertainties on proton dose plans.
  • To explore methods for achieving robust proton therapy plans.

Main Methods:

  • Review of existing literature on geometric uncertainties in proton therapy.
  • Analysis of the impact of proton range uncertainties on dose distribution.

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  • Investigation of advanced planning techniques, including uncertainty incorporation into optimization and multicriteria optimization frameworks.

    • Main Results:

    • Geometric uncertainties are present in proton therapy, similar to conventional radiotherapy.
    • Proton range uncertainties significantly impact dose plans, especially at the distal edge.
    • Patient-specific validation is crucial, and traditional planning target volumes (PTVs) may be insufficient for complex plans.
    • Incorporating uncertainties into optimization and multicriteria optimization shows promise for robust planning.

    Conclusions:

    • Accurate knowledge of proton range uncertainties is essential for robust treatment planning.
    • Advanced techniques like uncertainty-aware optimization and multicriteria optimization offer solutions.
    • The role of adaptive therapy in proton therapy requires further investigation.
    • Ensuring robustness to range uncertainties remains a key challenge in proton therapy.