ArticleJournal of applied clinical medical physics2021
Dosimetric impact of range uncertainty in passive scattering proton therapy.
Article in Journal of applied clinical medical physics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.
- A systematic literature review: deep learning techniques for synthetic medical image generation and their applications in radiotherapy.Frontiers in radiology · 2024Pooled it
- A single-field-each-peak optimization method for motion-robust proton LATTICE therapy.Medical physics · 2026Article
- Current state of proton therapy for tumors of the central nervous system in Spain: physical bases, indications, controversies and perspectives.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
- Prompt gamma timing for proton range verification with TlBr and TlCl as pure Cherenkov emitters.Physics in medicine and biology · 2024Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
purposeThe objective of this study was to investigate the dosimetric impact of range uncertainty in a large cohort of patients receiving passive scatter proton therapy.
methodsA cohort of 120 patients were reviewed in this study retrospectively, of which 61 were brain, 39 lung, and 20 prostate patients. Range uncertainties of ±3.5% (overshooting and undershooting by 3.5%, respectively) were added and recalculated on the original plans, which had been planned according to our clinical planning protocol while keeping beamlines, apertures, compensators, and dose grids intact. Changes in the coverage on CTV and DVH for critical organs were compared and analyzed. Correlation between dose change and minimal distance between CTV and critical organs were also investigated.
resultsAlthough CTV coverages and maximum dose to critical organs were largely maintained for most brain patients, large variations over 5% were still observed sporadically. Critical organs, such as brainstem and chiasm, could still be affected by range uncertainty at 4 cm away from CTV. Coverage and OARs in lung and prostate patients were less likely to be affected by range uncertainty with very few exceptions.
conclusionThe margin recipe in modern TPS leads to clinically acceptable OAR doses in the presence of range uncertainties. However, range uncertainties still pose a noticeable challenge for small but critical serial organs near tumors, and occasionally for large parallel organs that are located distal to incident proton beams.
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Registered trials
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