Comprehensive 4D robustness evaluation for pencil beam scanned proton plans

Cássia O Ribeiro; Arturs Meijers; Erik W Korevaar; Christina T Muijs; Stefan Both; Johannes A Langendijk; Antje Knopf

doi:10.1016/j.radonc.2019.03.037

Comprehensive 4D robustness evaluation for pencil beam scanned proton plans

Radiother Oncol. 2019 Jul:136:185-189. doi: 10.1016/j.radonc.2019.03.037. Epub 2019 Apr 20.

Authors

Cássia O Ribeiro¹, Arturs Meijers², Erik W Korevaar², Christina T Muijs², Stefan Both², Johannes A Langendijk², Antje Knopf²

Affiliations

¹ Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, The Netherlands. Electronic address: c.oraboni.ribeiro@umcg.nl.
² Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.

PMID: 31015123
DOI: 10.1016/j.radonc.2019.03.037

Abstract

Due to anticipated clinical benefits, moving targets are potential future indications for pencil beam scanned proton therapy (PBS-PT). However, currently they are not widely treated at PBS-PT facilities due to dosimetric uncertainties caused by motion. We developed a method, the 4D robustness evaluation method (4DREM), to realistically and efficiently assess all possible events impacting PBS-PT treatments in the thorax. Using the 4DREM in large cohorts of lung and oesophageal cancer patients, it will become possible to illustrate, in clinical practice, how to trigger robustness settings for plan optimisation and to select and apply motion mitigation techniques.

Keywords: 4D robustness evaluation; Lung cancer; Moving targets; Oesophagus cancer; Pencil beam scanned proton therapy; Voxel-wise worst-case dose.

MeSH terms

Esophageal Neoplasms / diagnostic imaging
Esophageal Neoplasms / radiotherapy*
Four-Dimensional Computed Tomography / methods
Humans
Lung Neoplasms / diagnostic imaging
Lung Neoplasms / radiotherapy*
Proton Therapy / methods*
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted