ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2021
Anatomic changes in head and neck intensity-modulated proton therapy: Comparison between robust optimization and online adaptation.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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30 citing papers in PubMed, 59 citations in OpenAlex.
- Nominal plan robustness may predict plan degradation in proton therapy for oropharyngeal head-and-neck cancer.Journal of applied clinical medical physics · 2026Article
- Terminology Proposal for Adaptive Particle Therapy Classification and Strategies.International journal of particle therapy · 2026Article
- Imaging, automation and workflow challenges for online adaptive proton therapy.Physics and imaging in radiation oncology · 2025Article
- Triggered plan adaptation using multi-image optimization for improved robustness in head-and-neck cancer proton therapy.Physics and imaging in radiation oncology · 2025Article
- Proton radiography interpretation with artificial intelligence for treatment deviation detection in proton therapy.Physics and imaging in radiation oncology · 2025Article
- Comparison of cone beam computed tomography post-processing methods for online adaptive proton therapy of prostate cancer.Physics and imaging in radiation oncology · 2025Article
- Time-saving potential of daily online adaptive proton therapy for head and neck cancers by reducing number of beams.Physics and imaging in radiation oncology · 2025Article
- A planning approach for online adaptive proton therapy to cope with cone beam computed tomography inaccuracies.Physics and imaging in radiation oncology · 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
- Towards faster plan adaptation for proton arc therapy using initial treatment plan information.Physics and imaging in radiation oncology · 2025Article
- Potential of automated online adaptive proton therapy to reduce margins for oesophageal cancer.Physics and imaging in radiation oncology · 2025Article
- Clinical advantages of incorporating predicted weekly anatomy in IMPT optimization with reduced setup error.Medical physics · 2024Article
- Unsupervised Deep Learning for Synthetic CT Generation from CBCT Images for Proton and Carbon Ion Therapy for Paediatric Patients.Sensors (Basel, Switzerland) · 2024Article
- Article
- Cone beam CT-based adaptive intensity modulated proton therapy assessment using automated planning for head-and-neck cancer.Radiation oncology (London, England) · 2024Article
- Article
- Evaluating the effect of setup uncertainty reduction and adaptation to geometric changes on normal tissue complication probability using online adaptive head and neck intensity modulated proton therapy.Physics in medicine and biology · 2023Article
- Online adaptive planning methods for intensity-modulated radiotherapy.Physics in medicine and biology · 2023Review
- Large anatomical changes in head-and-neck cancers - A dosimetric comparison of online and offline adaptive proton therapy.Clinical and translational radiation oncology · 2023Article
- Effectiveness of robust optimization against geometric uncertainties in TomoHelical planning for prostate cancer.Journal of applied clinical medical physics · 2023Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
Abstract
background/purposeSetup variations and anatomical changes can severely affect the quality of head and neck intensity-modulated proton therapy (IMPT) treatments. The impact of these changes can be alleviated by increasing the plan's robustness a priori, or by adapting the plan online. This work compares these approaches in the context of head and neck IMPT. MATERIALS/
methodsA representative cohort of 10 head and neck squamous cell carcinoma (HNSCC) patients with daily cone-beam computed tomography (CBCT) was evaluated. For each patient, three IMPT plans were created: 1- a classical robust optimization (cRO) plan optimized on the planning CT, 2- an anatomical robust optimization (aRO) plan additionally including the two first daily CBCTs and 3- a plan optimized without robustness constraints, but online-adapted (OA) daily, using a constrained spot intensity re-optimization technique only.
resultsThe cumulative dose following OA fulfilled the clinical objective of both the high-risk and low-risk clinical target volumes (CTV) coverage in all 10 patients, compared to 8 for aRO and 4 for cRO. aRO did not significantly increase the dose to most organs at risk compared to cRO, although the integral dose was higher. OA significantly reduced the integral dose to healthy tissues compared to both robust methods, while providing equivalent or superior target coverage.
conclusionUsing a simple spot intensity re-optimization, daily OA can achieve superior target coverage and lower dose to organs at risk than robust optimization methods.
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