ArticlePhysics and imaging in radiation oncology2025
A planning approach for online adaptive proton therapy to cope with cone beam computed tomography inaccuracies.
Article in Physics and imaging in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Reduction of organ of interest dose in proton therapy for oesophageal cancer through optimized setup robustness settings and online adaptation.Physics and imaging in radiation oncology · 2026Article
- Imaging, automation and workflow challenges for online adaptive 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
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose: In online-adaptive proton therapy planning based on cone beam computed tomography (CBCT), CT number errors can pose challenges. We propose an approach for coping with CT number uncertainties by increasing range robustness settings (RRS) in online-adaptive planning. This was compared to our trigger-based offline (TB-Offline) adaptive approach, and to daily replanning using in-room CT-on-rails (CTOR). Material and methods: For 23 head-and-neck cancer patients, a CTOR and CBCT were acquired in a single fraction. CTOR contours were copied rigidly onto the CBCT. CBCT-based plans were generated with 3, 6, 8, 10, and 12 % RRS, each with 1 mm setup-RS, followed by a forward dose calculation on the reference CTOR. This was compared to dose distributions from our TB-Offline approach (3 mm/3% SRS/RRS), also recomputed on the CTOR. Coverage (voxelwise-minimum) of the primary clinical target volume (CTV Results: When going from RRS = 3 % to RRS = 10 %, the population 90th percentiles of CTV Conclusions: Robust optimization with increased range robustness settings effectively mitigated dose degradation from CT number errors in CBCT-based online-adaptive proton therapy.
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