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Updated: Jul 20, 2025

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Parameter based 4D dose calculations for proton therapy.

Franciska Lebbink1,2, Silvia Stocchiero1,2, Piero Fossati2,3

  • 1Medical University of Vienna, Department of Radiation Oncology, Vienna, Austria.

Physics and Imaging in Radiation Oncology
|July 31, 2023
PubMed
Summary
This summary is machine-generated.

A new prospective tool accurately predicts motion sensitivity in proton therapy. This parameter-based 4D dose calculation (p-4DDC) method can guide treatment planning and motion mitigation strategies for cancer patients.

Keywords:
4DDose calculationsInterplayLiver and pancreatic cancerMeasurementsPencil beam scanningProton therapy

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Computational Biology

Background:

  • Retrospective log file analysis estimates delivered dose in proton therapy but lacks prospective prediction.
  • Patient-specific motion sensitivity prediction requires a tool implemented before treatment initiation.
  • A novel parameter-based tool for prospective four-dimensional dose calculation (4DDC) has been developed and evaluated.

Purpose of the Study:

  • To investigate a parameter-based 4DDC (p-4DDC) method for predicting motion sensitivity in scanned pulsed proton beam therapy.
  • To validate the p-4DDC method using an anthropomorphic phantom and patient data against measurements and a log file-based 4DDC tool.
  • To assess the impact of breathing motion on dose-volume histogram parameters for targets and organs at risk.

Main Methods:

  • Performed 4DDC for seven cancer patients undergoing scanned pulsed proton beam therapy with small breathing motion.
  • Validated the p-4DDC method against measured data and a log file-based 4DDC tool.
  • Analyzed dose-volume histogram parameters for target volumes and organs at risk, comparing static, log file-based, and p-4DDC results.

Main Results:

  • The p-4DDC method demonstrated dose prediction accuracy within measurement deviations (max 0.4 Gy).
  • For the planning target volume, p-4DDC and log file results agreed within 2%, with variations up to 15% compared to static calculations.
  • For liver and pancreas patients, p-4DDC showed deviations of 10% and 11% compared to log file-based 4DDC, respectively.

Conclusions:

  • The parameter-based 4D dose calculation (p-4DDC) method is suitable for prospective use in clinical settings.
  • The p-4DDC tool can assist in adapting treatment plans or implementing motion mitigation strategies.
  • Clinical implementation of the p-4DDC tool is the next logical step to enhance proton therapy precision.