ArticleFrontiers in oncology2025
The impact of dose rate optimisation and robust optimisation on FLASH proton therapy treatment plan quality and dose rates.
Article in Frontiers in 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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4 authors.
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Abstract
Background and purpose: Bragg peak FLASH proton therapy (FLASH-PT) relies on fast dose delivery (≥ 40 Gy/s) to elicit a normal tissue sparing effect. FLASH-PT beam delivery modifications lead to inferior margin-based FLASH-PT treatment plan quality compared to intensity modulated proton therapy (IMPT). To achieve ultra-high dose rates to regions of interest, dose rate optimisation may need to be utilised as part of the treatment planning process. This study aims to determine the impact of dose rate optimisation and robust optimisation on FLASH-PT treatment plan quality and achievable dose rates. All FLASH-PT plans are also compared to IMPT plans to determine the clinical applicability of the technique. Materials and methods: FLASH-PT and IMPT treatment plans were generated for bone ( Results and conclusion: Dose rate optimised FLASH-PT plans were associated with significantly worse target dose coverage, whilst significantly improving dose rate coverages to organs at risk, compared to non-dose rate optimised plans. The use of dose rate optimisation should be used with caution as it may lead to degraded plan quality. Robust optimisation improved target coverage compared to margin-based plans, without compromising dose rate coverage. FLASH-PT plans struggle to achieve IMPT-equivalent D
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