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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Adaptive proton therapy.

Harald Paganetti1,2, Pablo Botas1,2,3, Gregory C Sharp1,2

  • 1Department of Radiation Oncology, Physics Division, Massachusetts General Hospital, Boston, Massachusetts, United States of America.

Physics in Medicine and Biology
|October 28, 2021
PubMed
Summary
This summary is machine-generated.

Adaptive radiation therapy accounts for anatomical changes during treatment. Online adaptation in proton therapy, using onboard imaging, is crucial for precise dose delivery due to proton beam characteristics.

Keywords:
adaptive radiation therapyonline adaptationproton therapy

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiotherapy Technology

Background:

  • Radiation therapy planning assumes constant patient anatomy and dose response.
  • Anatomical and biological variations occur on multiple timescales during treatment.
  • Adaptive radiation therapy addresses these changes, traditionally via offline replanning.

Purpose of the Study:

  • To review the current state of online adaptive proton therapy.
  • To highlight the importance of adaptation in proton therapy.
  • To identify areas for future research in online adaptive proton therapy.

Main Methods:

  • Review of current literature on online adaptive proton therapy.
  • Discussion of advancements in imaging and treatment delivery systems.
  • Analysis of dose perturbations in proton therapy due to anatomical changes.

Main Results:

  • Online treatment adaptation using onboard imaging is gaining momentum.
  • Proton therapy requires adaptation due to dose conformity and finite beam range.
  • Small anatomical changes can cause significant dose perturbations in proton therapy.

Conclusions:

  • Online adaptive radiation therapy is essential for precise treatment delivery.
  • Further research is needed to advance online adaptive proton therapy techniques.
  • Adaptive strategies are critical for optimizing outcomes in proton therapy.