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A survey of practice patterns for adaptive particle therapy for interfractional changes
Petra Trnkova1, Ye Zhang2, Toshiyuki Toshito3
1Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria.
Physics and Imaging in Radiation Oncology
|May 17, 2023
Summary
Adaptive particle therapy (APT) is widely used offline, but online daily re-planning is limited. Key barriers to online APT include workflow integration and automation, requiring industry-clinic collaboration for broader implementation.
Area of Science:
- Medical Physics
- Radiation Oncology
- Particle Therapy
Background:
- Anatomical changes during particle therapy can affect target coverage and organ-at-risk doses.
- Adaptive particle therapy (APT) aims to address these changes for improved treatment accuracy.
Purpose of the Study:
- To evaluate current clinical practice patterns of adaptive particle therapy (APT).
- To identify wishes and barriers for further implementation of APT worldwide.
Main Methods:
- An international institutional questionnaire was distributed to particle therapy (PT) centers.
- A three-round Delphi consensus analysis was conducted among authors.
Main Results:
- 84% of centers use APT, primarily offline, with head and neck treatments most common.
- Lack of integrated workflows is the main barrier; automation, dose accumulation, and imaging quality are crucial for online APT.
Conclusions:
- Offline APT is the predominant approach; online daily re-planning is rare.
- Industry-clinic collaboration is essential to develop efficient workflows for widespread online APT adoption.
Keywords:
Adaptive radiotherapy (ART)Adaptive treatment planningImage guided particle therapyInterfraction anatomical variationParticle/proton therapy
