Development and clinical application of a probabilistic robustness evaluation tool for pencil beam scanning proton therapy treatments.

Purpose: to implement a probabilistic-Robustness-Evaluation (pRE) tool for proton therapy treatments and to correlate these results with the worst-case approach (wRE) implemented in commercial TPS for clinical applications.

Materials And Methods: 12 skull base patients were planned with a robust multiple field optimization (MFO) approach. 10 years of machine QA were analysed to derive the uncertainties of our treatment system (beam delivery and patient positioning system).

Static proton arc therapy: Comprehensive plan quality evaluation and first clinical treatments in patients with complex head and neck targets.

Background: Proton Arc Treatment (PAT) has shown potential over Multi-Field Optimization (MFO) for out-of-target dose reduction in particular for head and neck (H&N) patients. A feasibility test, including delivery in a clinical environment is still missing in the literature and a necessary requirement before clinical application of PAT.

Purpose: To perform a comprehensive comparison between clinically delivered MFO plans and static PAT plans for H&N treatments, followed by end-to-end commissioning of the system to prepare for clinical treatments.

ESTRO-EPTN radiation dosimetry guidelines for the acquisition of proton pencil beam modelling data.

Proton therapy (PT) is an advancing radiotherapy modality increasingly integrated into clinical settings, transitioning from research facilities to hospital environments. A critical aspect of the commissioning of a proton pencil beam scanning delivery system is the acquisition of experimental beam data for accurate beam modelling within the treatment planning system (TPS). These guidelines describe in detail the acquisition of proton pencil beam modelling data.

Dosimetric and NTCP advantages of robust proton therapy over robust VMAT for Stage III NSCLC in the immunotherapy era.

Aims: To assess the robustness and to define the dosimetric and NTCP advantages of pencil-beam-scanning proton therapy (PBSPT) compared with VMAT for unresectable Stage III non-small lung cancer (NSCLC) in the immunotherapy era.

Material And Methods: 10 patients were re-planned with VMAT and PBSPT using: 1) ITV-based robust optimization with 0.5 cm setup uncertainties and (for PBSPT) 3.