ArticleJournal of applied clinical medical physics2022
Small spot size versus large spot size: Effect on plan quality for lung cancer in pencil beam scanning proton therapy.
Article in Journal of applied clinical medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 13 citations in OpenAlex.
- Improved organs-of-interest dose reduction potential with intensity modulated proton therapy and breath-hold in mediastinal lymphoma.Physics and imaging in radiation oncology · 2026Article
- Dosimetric comparison of scanned proton therapy and volumetric modulated arc therapy in isodose-prescribed stereotactic body radiotherapy for lung cancer.Journal of radiation research · 2026Article
- Comparison of a Multi-Scenario Robustness Evaluation Method with Measurements for Proton Teletherapy.Cancers · 2025Article
- Quantification of beam size impact on intensity-modulated proton therapy with robust optimization in head and neck cancer-comparison with intensity-modulated radiation therapy.Journal of radiation research · 2025Article
- Initial experience and patient tolerance of proton stereotactic body radiotherapy.Journal of radiosurgery and SBRT · 2024Article
- Small spot size versus large spot size: Effect on plan quality for lung cancer in pencil beam scanning proton therapy.Journal of applied clinical medical physics · 2022Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of the current study was to evaluate the impact of spot size on the interplay effect, plan robustness, and dose to the organs at risk for lung cancer plans in pencil beam scanning (PBS) proton therapy
methodsThe current retrospective study included 13 lung cancer patients. For each patient, small spot (∼3 mm) plans and large spot (∼8 mm) plans were generated. The Monte Carlo algorithm was used for both robust plan optimization and final dose calculations. Each plan was normalized, such that 99% of the clinical target volume (CTV) received 99% of the prescription dose. Interplay effect was evaluated for treatment delivery starting in two different breathing phases (T0 and T50). Plan robustness was investigated for 12 perturbed scenarios, which combined the isocenter shift and range uncertainty. The nominal and worst-case scenario (WCS) results were recorded for each treatment plan. Equivalent uniform dose (EUD) and normal tissue complication probability (NTCP) were evaluated for the total lung, heart, and esophagus.
resultsIn comparison to large spot plans, the WCS values of small spot plans at CTV D
conclusionFor robustly optimized PBS lung cancer plans in our study, a small spot machine resulted in a more robust CTV against the setup and range errors when compared to a large spot machine. In the absence of volumetric repainting, large spot PBS lung plans were more robust against the interplay effect. The use of a volumetric repainting technique in both small and large spot PBS lung plans led to comparable interplay target coverage.
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