ArticlePhysics and imaging in radiation oncology2020
Online adaptive dose restoration in intensity modulated proton therapy of lung cancer to account for inter-fractional density changes.
Article in Physics and imaging in radiation oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 29 citations in OpenAlex.
- Patient-Specific Deep Reinforcement Learning for Proton Beam Delivery Under Inter-Phase Variations.International journal of particle therapy · 2026Article
- Terminology Proposal for Adaptive Particle Therapy Classification and Strategies.International journal of particle therapy · 2026Article
- Interfractional body surface monitoring using daily cone-beam computed tomography imaging for pediatric adaptive proton therapy.Physics and imaging in radiation oncology · 2025Article
- Assessment of clinical feasibility:offline adaptive radiotherapy for lung cancer utilizing kV iCBCT and UNet++ based deep learning model.Journal of applied clinical medical physics · 2025Article
- Current status and upcoming developments for online adaptive proton therapy enabling a closed feedback loop for near real-time adaptation.Frontiers in oncology · 2025Review
- Potential of automated online adaptive proton therapy to reduce margins for oesophageal cancer.Physics and imaging in radiation oncology · 2025Article
- Towards faster plan adaptation for proton arc therapy using initial treatment plan information.Physics and imaging in radiation oncology · 2025Article
- A review of the clinical introduction of 4D particle therapy research concepts.Physics and imaging in radiation oncology · 2024Review
- Comparison of 3D and 4D robustly optimized proton treatment plans for non-small cell lung cancer patients with tumour motion amplitudes larger than 5 mm.Physics and imaging in radiation oncology · 2023Article
- Surveying the clinical practice of treatment adaptation and motion management in particle therapy.Physics and imaging in radiation oncology · 2023Article
- Image guidance and interfractional anatomical variation in paediatric abdominal radiotherapy.The British journal of radiology · 2023Article
- Online adaptive planning methods for intensity-modulated radiotherapy.Physics in medicine and biology · 2023Review
- A survey of practice patterns for adaptive particle therapy for interfractional changes.Physics and imaging in radiation oncology · 2023Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeIn proton therapy, inter-fractional density changes can severely compromise the effective delivery of the planned dose. Such dose distortion effects can be accounted for by treatment plan adaptation, that requires considerable automation for widespread implementation in clinics. In this study, the clinical benefit of an automatic online adaptive strategy called dose restoration (DR) was investigated. Our objective was to assess to what extent DR could replace the need for a comprehensive offline adaptive strategy. MATERIALS AND
methodsThe fully automatic and robust DR workflow was evaluated in a cohort of 14 lung IMPT patients that had a planning-CT and two repeated 4D-CTs (rCT1,rCT2). Initial plans were generated using 4D-robust optimization (including breathing-motion, setup and range errors). DR relied on isodose contours generated from the initial dose and associated patient specific weighted objectives to mimic this initial dose in repeated-CTs. These isodose contours, with their corresponding objectives, were used during re-optimization to compensate proton range distortions disregarding re-contouring. Robustness evaluations were performed for the initial, not-adapted and restored (adapted) plans.
resultsThe resulting DVH-bands showed overall improvement in DVH metrics and robustness levels for restored plans, with respect to not-adapted plans. According to CTV coverage criteria (D95%>95%Dprescription) in not-adapted plans, 35% (5/14) of the cases needed offline adaptation. After DR, Median(D95%) was increased by 1.1 [IQR,0.4] Gy and only one patient out of 14 (7%) still needed offline adaptation because of important anatomical changes.
conclusionsDR has the potential to improve CTV coverage and reduce offline adaptation rate.
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