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SU-E-T-295: Factors Affecting Accuracy in Proton Therapy.

C Cheng1,2, L Zhao1,2, Q Zhao1,2

  • 1Indiana University- School of Medicine, Bloomington, IN.

Medical Physics
|May 19, 2017
PubMed
Summary

Proton therapy accuracy is complex, with preliminary findings indicating at least a ±4.5% dose uncertainty and ±4mm range uncertainty. Further research is needed to fully quantify all contributing factors for precise proton therapy outcomes.

Keywords:
CancerComputed tomographyData analysisDrug deliveryError analysisMedical imagingMedical treatment planningNeutronsProton therapyProtons

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Area of Science:

  • Medical Physics
  • Radiation Oncology

Background:

  • Proton therapy offers precise dose delivery but involves complex processes.
  • Understanding uncertainties in each step is crucial for accurate treatment outcomes.

Purpose of the Study:

  • To examine the processes involved in proton therapy.
  • To assess the effects of these processes on treatment accuracy.

Main Methods:

  • Analyzed subprocesses within key proton therapy steps: beam commissioning, CT scanning, contouring, treatment planning, output factor measurements, image guidance, dose delivery, and neutron dose/RBE.
  • Estimated percentage or distance uncertainties for each sub-process based on measurements and published data.

Main Results:

  • Quantified uncertainties for specific processes: beam commissioning (±1.5%), treatment planning (±3.0%, 1-3mm), output factors (±2.0%), image guidance (±2mm), and dose delivery (±2.0%, ±2mm).
  • Identified significant uncertainties in CT, contouring, and neutron dose dependent on tumor characteristics.
  • Highlighted the proton Relative Biological Effectiveness (RBE) at the distal edge as a major area of debate, potentially causing 0-20% dose uncertainty.

Conclusions:

  • Assessing proton therapy accuracy is complex due to numerous contributing factors.
  • Preliminary results suggest an overall uncertainty of at least ±4.5% in delivered dose and ±4mm in range to the Spread-Out Bragg Peak (SOBP) distal edge.