The impact of the titanium cranial hardware in proton single-field uniform dose plans.

Background: Neurosurgical cranial titanium mesh and screws are commonly encountered in postoperative radiation therapy. However, only a limited number of reports are available in the context of proton therapy, resulting in a lack of consensus among the proton centers regarding the protocol for handling the hardware.

Purpose: This study is to examine the impact of the hardware in proton plans.