ArticlePhysics and imaging in radiation oncology2026
Interplay effect evaluation on lung and esophageal cancer patients treated with compact proton system in free breathing.
Article in Physics and imaging in radiation oncology, 2026. 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: Pencil beam scanning proton therapy is sensitive to respiratory motion, which can cause dose discrepancies due to the interplay between tumor and beam delivery motion. This study evaluates the clinical impact of interplay for lung and esophageal cancer patients treated in free-breathing, without rescanning. Materials and methods: Interplay was evaluated in 36 patients (18 lung, 18 esophageal) using both predictive and Results: The predictive method agreed closely with Conclusions: Internal target volume-based robust optimization combined with machine-specific beam delivery characteristics provides motion robustness for most lung and esophageal patients treated in free-breathing. Additional motion mitigation was not required for most patients treated under conventional fractionation. However, small targets with large motion remain at risk of interplay-induced underdosage, warranting caution, as this combination may compromise plan robustness.
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