Cancers, Vol. 10, Pages 7: Clinical Implementation of Robust Optimization for Craniospinal Irradiation

Cancers, Vol. 10, Pages 7: Clinical Implementation of Robust Optimization for Craniospinal Irradiation Cancers doi: 10.3390/cancers10010007 Authors: Alexandria Tasson Nadia Laack Chris Beltran With robust optimization for spot scanning proton therapy now commercially available, the ability exists to account for setup, range, and interfield uncertainties during optimization. Robust optimization is particularly beneficial for craniospinal irradiation (CSI) where the large target volume lends itself to larger setup uncertainties and the need for robust match lines can all be handled with the uncertainty parameters found inside the optimizer. Suggested robust optimization settings, parameters, and image guidance for CSI patients using proton therapy spot scanning are provided. Useful structures are defined and described. Suggestions are given for perturbations to be entered into the optimizer in order to achieve a plan that provides robust target volume coverage and critical structure sparing as well as a robust match line. Interfield offset effects, a concern when using multifield optimization, can also be addressed within the robust optimizer. A robust optimizer can successfully be employed to produce robust match lines, target volume coverage, and critical structure sparing under specified uncertainties. The robust optimizer can also be used to reduce effects arising from interfield uncertainties. Using robust optimization, a plan robust against setup, range, and i...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Technical Note Source Type: research