Authors
Unkelbach, JAlber, M
Bangert, M
Bokrantz, R
Chan, TCY
Deasy, JO
Fredriksson, A
Gorissen, BL
van Herk, Marcel
Liu, W
Mahmoudzadeh, H
Nohadani, O
Siebers, JV
Witte, M
Xu, HJ
Affiliation
Department of Radiation Oncology, University Hospital Zurich, ZurichIssue Date
2018
Metadata
Show full item recordAbstract
Motion and uncertainty in radiotherapy is traditionally handled via margins. The clinical target volume (CTV) is expanded to a larger planning target volume (PTV), which is irradiated to the prescribed dose. However, the PTV concept has several limitations, especially in proton therapy. Therefore, robust and probabilistic optimization methods have been developed that directly incorporate motion and uncertainty into treatment plan optimization for intensity modulated radiotherapy (IMRT) and intensity modulated proton therapy (IMPT). Thereby, the explicit definition of a PTV becomes obsolete and treatment plan optimization is directly based on the CTV. Initial work focused on random and systematic setup errors in IMRT. Later, inter-fraction prostate motion and intra-fraction lung motion became a research focus. Over the past ten years, IMPT has emerged as a new application for robust planning methods. In proton therapy, range or setup errors may lead to dose degradation and misalignment of dose contributions from different beams - a problem that cannot generally be addressed by margins. Therefore, IMPT has led to the first implementations of robust planning methods in commercial planning systems, making these methods available for clinical use. This paper first summarizes the limitations of the PTV concept. Subsequently, robust optimization methods are introduced and their applications in IMRT and IMPT planning are reviewed.Citation
Unkelbach J, Alber M, Bangert M, Bokrantz R, Chan T, Deasy J, et al. Robust radiotherapy planning. Phys Med Biol. 2018 Nov 12;63(22):22.Journal
Physics in Medicine and BiologyDOI
10.1088/1361-6560/aae659PubMed ID
30418942Additional Links
https://dx.doi.org/10.1088/1361-6560/aae659Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1088/1361-6560/aae659
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