The worst-case scenario survival guide: uncertainties in proton therapy

Abstract

Abstract text The finite range and sharp distal dose fall-off of proton beams can confer an advantage compared to photons when it comes to producing dose distributions within a patient but these same properties make proton plans more sensitive to various uncertainties. This talk will address the main sources of uncertainty in proton therapy and their effects on the delivered dose distribution. We will look at how plans can be evaluated in the face of uncertainty and what we should look at when what we are used to seeing on screen in the treatment planning system may be unreliable. We will discuss what can be done to mitigate the effects of inevitable uncertainties, what should be anticipated upfront and whether it is always worth the cost of being robust to uncertainty.