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Updated: Dec 17, 2025

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

Fraction-variant beam orientation optimization for intensity-modulated proton therapy.

Wenbo Gu¹, Daniel O'Connor¹, Dan Ruan¹

¹Department of Radiation Oncology, University of California-Los Angeles, Los Angeles, CA, 90095, USA.

Medical Physics

|June 22, 2020

Summary

Fraction-variant beam orientation optimization improves intensity-modulated proton therapy (IMPT) dosimetry by varying beam angles across fractions, sparing organs at risk while using few beams per session.

Keywords:

fraction variant intensity modulated proton therapy optimization

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Area of Science:

Radiation Oncology
Medical Physics
Computational Biology

Background:

Intensity-modulated proton therapy (IMPT) aims to optimize dose delivery.
Balancing dosimetry and delivery efficiency in IMPT is challenging.
Minimizing beam usage per fraction is desirable for efficiency.

Purpose of the Study:

To develop a method for optimizing beam selection in IMPT to improve dose distribution and delivery efficiency.
To achieve superior dosimetry with a minimal number of beams per fraction by varying beam orientations across fractions.

Main Methods:

Formulated the fraction-variant beam orientation optimization (FVBOO) problem.
Included quadratic dose fidelity terms and an L2,1/2-norm group sparsity term to control beam count (1-4 per fraction).
Applied the Fast Iterative Shrinkage-Thresholding Algorithm (FISTA) and tested on base-of-skull, head-and-neck, and esophageal cancer patients.

Main Results:

FVBOO plans demonstrated superior organ-at-risk (OAR) sparing compared to fixed-beam plans.
Average OAR dose reduction ranged from 0.85 to 4.06 GyRBE.
FVBOO achieved comparable or superior dosimetry with fewer beams per fraction.

Conclusions:

Fraction-variant beam orientation optimization enhances IMPT dose distribution.
This approach allows exploration of a larger beam solution space.
FVBOO maintains a practical number of beams per fraction for efficient treatment delivery.