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

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

Published on: February 6, 2019

Online daily adaptive proton therapy.

Francesca Albertini¹, Michael Matter^1,2, Lena Nenoff^1,2

¹Paul Scherrer Institute, Center for Proton Therapy, Switzerland.

The British Journal of Radiology

|October 25, 2019

Summary

Adaptive radiotherapy, especially with protons, requires frequent plan adjustments due to anatomical changes. Online adaptive strategies are crucial for accurate daily dosing and improved treatment quality.

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Area of Science:

Medical Physics
Radiation Oncology
Radiotherapy Technology

Background:

Single radiotherapy plans based on old imaging are often inaccurate for daily dose delivery, particularly with proton therapy's finite range.
Anatomical variations significantly impact dose accuracy and treatment quality in radiotherapy.
Proton therapy's steep dose gradients necessitate precise range accuracy, making anatomical changes critical.

Purpose of the Study:

To review the adaptive radiotherapy workflow, focusing on online strategies.
To discuss challenges and current developments in online adaptive radiotherapy.
To highlight the importance of adapting treatment plans to daily anatomical variations.

Main Methods:

Detailed description of the adaptive radiotherapy workflow steps.
Discussion of challenges associated with online adaptive strategies.
Review of state-of-the-art developments in adaptive radiotherapy.

Main Results:

Outdated patient anatomy is a major cause of range inaccuracy in proton therapy.
Online adaptation is essential to address anatomical variations and ensure dose accuracy.
Current developments aim to improve the efficiency and effectiveness of online adaptive workflows.

Conclusions:

Adaptive radiotherapy, especially online, is vital for accurate proton therapy.
Addressing anatomical variations in real-time is key to optimizing dose distribution.
Continued development of online adaptive strategies is necessary for advancing conformal radiotherapy.