[Robust treatment planning in proton therapy]. / Planification de traitement robuste en protonthérapie.
Cancer Radiother
; 20(6-7): 523-9, 2016 Oct.
Article
in Fr
| MEDLINE
| ID: mdl-27614528
ABSTRACT
The concentration of the dose delivered by protons at the end of their path, the Bragg peak, has the potential to improve external radiotherapy treatments. Unfortunately, the main strength of the protons, their finite range, is also their greatest weakness. Any uncertainty on the range may lead to inadequate target coverage or excessive toxicity. The uncertainties have multiple origins and include, among others, ballistic errors, morphological modifications or inaccurate estimations of the physical quantities necessary to predict the proton range. Uncertainties have been part of daily practice in conventional radiotherapy with X-rays for a long time. However, dose distributions delivered with X-rays are much less sensitive to uncertainties than the ones delivered with protons. This relative insensitivity enabled the management of uncertainties through safety margins using a simple formalism. The conditions of validity of this formalism are much more restrictive for proton therapy, leading to the need of developing new tools and adapted strategies to manage accurately these uncertainties. The objective of this paper is to present a vision for the management of uncertainties in proton therapy in the continuity of formalisms established for X-rays. The latter are first summarized before discussing the necessary developments in order to consistently apply them to protons.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Radiotherapy Planning, Computer-Assisted
/
Radiotherapy, Image-Guided
/
Proton Therapy
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
Fr
Journal:
Cancer Radiother
Journal subject:
NEOPLASIAS
/
RADIOTERAPIA
Year:
2016
Document type:
Article