ArticlePhysics and imaging in radiation oncology2025
Triggered plan adaptation using multi-image optimization for improved robustness in head-and-neck cancer proton therapy.
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. Not yet cited in PubMed.
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Abstract
Background and purpose: Anatomical variations in head-and-neck (HNC) proton therapy may degrade target coverage and organ-at-risk (OAR) sparing. This study introduces a triggered robust adaptation strategy utilizing multi-image optimization to progressively enhance plan robustness guided by observed dose deviations for targets and OARs. Material and methods: Five oropharyngeal cancer patients treated with proton therapy were retrospectively analyzed. Synthetic computed tomography (CT) scans were generated from daily cone-beam CTs for dose recalculation. Four strategies were compared: no adaptation ( Results: Conclusion: Triggered robust adaptation balanced target coverage and OAR sparing, while requiring fewer adaptations compared to triggered adaptation without anatomical robustness. It offers a potential pathway for implementing anatomical robust optimization in HNC proton therapy without relying on predicted images or additional CT scans.
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