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On the Way to Accounting for Lung Modulation Effects in Particle Therapy of Lung Cancer Patients-A Review
Matthias Witt1,2,3, Uli Weber1,4,5, Veronika Flatten6
1Institute of Medical Physics and Radiation Protection, University of Applied Sciences, 35390 Giessen, Germany.
Abstract:
Particle therapy presents a promising alternative to conventional photon therapy for treating non-small cell lung cancer (NSCLC). However, the heterogeneous structure of lung tissue leads to the degradation of the Bragg peak and thereby to the degradation of the dose distribution. This review offers a comprehensive overview of the models developed to account for these modulation effects. It summarizes studies focused on determining modulation power as a predictor of this so-called lung modulation. In addition, the review covers early investigations on dose uncertainties caused by lung modulation in CT-based lung phantoms and patient anatomies and discusses future challenges in integrating these solutions into clinical treatment planning routines.
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