ArticlePhysics and imaging in radiation oncology2025
Partial adaptation for online-adaptive proton therapy triggered by during-delivery treatment verification: Feasibility study on prostate cancer treatments.
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 2 papers.
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Who cites it
2 citing papers in PubMed.
- Imaging, automation and workflow challenges for online adaptive proton therapy.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
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Authors and funding
7 authors.
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Abstract
Background and Purpose: Online treatment verification during proton therapy delivery may detect deviations due to anatomical changes occurring along the treatment course and trigger immediate intervention, if necessary. We investigated the potential of partial plan adaptation in two-field prostate cancer treatments as a solution for online-adaptive proton therapy (OAPT) after the detection of relevant treatment deviations during the first field delivery. Materials and Methods: In a retrospective study, ten fractions from eight prostate cancer patients with prompt gamma imaging (PGI) detected treatment deviations, which were confirmed on respective in-room control computed tomography (cCT) scans, were considered. For each cCT, a dose-mimicking-based robust partial adaptation reoptimized the second field by considering the suboptimal dose delivery of the first non-adapted, PGI-monitored field. The results were compared to the non-adapted scenario and upfront full adaptation (both fields) in terms of achievable target coverage (prescription: 48 Gy/60 Gy to low-risk/high-risk target) and organ-at-risk (OAR) sparing. Results: Partially adapted plans showed comparable target coverage (median Conclusions: Partial adaptation triggered mid-delivery of a fraction can still generate plans of comparable conformity to full adaptation, even in the case of plans with only two, opposing fields. A verification-triggered OAPT may therefore become an alternative to upfront OAPT, saving time and imaging dose in fractions without relevant anatomy changes.
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