The influence of daily imaging and target margin reduction on secondary cancer risk in image-guided and adaptive proton therapy.

. Image-guided and adaptive proton therapy rely on daily CBCT or CT imaging, which increases radiation dose and radiation-induced cancer risk. Online adaptation however also reduces setup uncertainty, and the additional risk might be compensated by reducing the setup robustness margin.

First clinical implementation of a highly efficient daily online adapted proton therapy (DAPT) workflow.

This study presents the first clinical implementation of an efficient online daily adaptive proton therapy workflow (DAPT).The DAPT workflow includes awhere aand aare optimized on the planning computed tomography (CT). In the, theis re-optimized on daily images from an in-room CT.

Multi-institutional experimental validation of online adaptive proton therapy workflows.

To experimentally validate two online adaptive proton therapy (APT) workflows using Gafchromic EBT3 films and optically stimulated luminescent dosimeters (OSLDs) in an anthropomorphic head-and-neck phantom.A three-field proton plan was optimized on the planning CT of the head-and-neck phantom with 2.0 Gy(RBE) per fraction prescribed to the clinical target volume.

Optically stimulated luminescence dosimeters for simultaneous measurement of point dose and dose-weighted LET in an adaptive proton therapy workflow.

Purpose: To demonstrate the suitability of optically stimulated luminescence detectors (OSLDs) for accurate simultaneous measurement of the absolute point dose and dose-weighted linear energy transfer (LET) in an anthropomorphic phantom for experimental validation of daily adaptive proton therapy.

Methods: A clinically realistic intensity-modulated proton therapy (IMPT) treatment plan was created based on a CT of an anthropomorphic head-and-neck phantom made of tissue-equivalent material. The IMPT plan was optimized with three fields to deliver a uniform dose to the target volume covering the OSLDs.

A review of the clinical introduction of 4D particle therapy research concepts.

Background And Purpose: Many 4D particle therapy research concepts have been recently translated into clinics, however, remaining substantial differences depend on the indication and institute-related aspects. This work aims to summarise current state-of-the-art 4D particle therapy technology and outline a roadmap for future research and developments.

Material And Methods: This review focused on the clinical implementation of 4D approaches for imaging, treatment planning, delivery and evaluation based on the 2021 and 2022 as well as a review of the most recent surveys, guidelines and scientific papers dedicated to this topic.