A rapid script-based framework for rotational robustness evaluation in lateral-opposed IMPT under customized setup...

Area of Science:

• Medical Physics
• Radiation Oncology
• Proton Therapy

Background:

• Lateral-opposed intensity-modulated proton therapy (LO-IMPT) requires robust treatment planning.
• Assessing rotational setup errors is crucial for plan efficacy and patient safety.

Purpose of the Study:

• To develop and validate a rapid, script-based framework for evaluating the rotational robustness of LO-IMPT plans.
• To enable customized setup scenario assessments for clinical and institutional needs.

Main Methods:

• A custom RayStation 10B API script was developed to simulate pitch, roll, and yaw errors.
• Rotational errors were applied at varying magnitudes (±1°, ±3°, ±5°) to LO-IMPT plans.
• The framework's feasibility was tested on nine patient cases (prostate, pituitary adenomas, foot sarcoma).

Main Results:

• The framework successfully generated 78 perturbed scenarios per plan.
• Prostate LO-IMPT plans demonstrated robustness to rotations up to ±5°.
• Pituitary adenoma and foot sarcoma plans showed significant patient-specific sensitivity to rotational errors.

Conclusions:

• The developed framework is an efficient, reproducible, and customizable tool for rotational robustness evaluation in LO-IMPT.
• It supports institution-specific robustness strategies and informs clinical decision-making regarding rotational uncertainties.