A survey of practice patterns for adaptive particle therapy for interfractional changes

Comparing different boost concepts and beam configurations for proton therapy of pancreatic cancer

“…Beam arrangements considering the minimization of dose variability in the stomach and duodenum are necessary to reduce the toxicity risk. Adaptive planning is an increasing concern in particle therapy [35] . However, the optimal method has not fully been established [36] , [37] .…”

A review of the clinical introduction of 4D particle therapy research concepts

“…A1; Table A1 ) and previous reports of those workshops [2] , [3] , [4] , [5] , [6] , [7] . The content of these meetings, surveys and guidelines [8] , [9] , [37] , [38] , [39] , [40] , [41] , [42] , [43] and relevant articles in the field of 4D PT, mainly published within the last 3 years, built the scientific basis for identifying the way towards clinical implementation of selected motion management and 4D treatment strategies. The literature review was based on a PubMed search (status September 2023).…”

“…For offline adaptation concepts implemented in many photon and PT centres [8] , [37] , tailored institutional solutions for specific treatment sites have been developed. Mobile in-room CT was shown to provide adequate acquisition time, geometric accuracy and image quality as well as SPR conversion as a basis for offline replanning and contour propagation [119] , [120] , [121] .…”

“…Currently, online daily radiotherapy solutions are commercially available only for photon therapy with dedicated platforms using MR guidance [42] or AI-guided CBCT-based systems [125] . However, also the field of PT shows broad interest in implementing more online or hybrid approaches, especially including daily replanning and employing plan libraries [8] , [22] , [126] , [127] , [128] . Recently, several key players in the field of real-time adaptive PT joined forces [129] to tackle the remaining challenges and pave the way towards online adaptation in PT [130] , [131] , [132] , [133] , [134] , [135] , [136] .…”

“…Looking back 15 years, leading scientists in the field of PT set ambitious aims for four-dimensional (4D) particle therapy with real-time respiratory motion management that included major developments (e.g., implementation of spot scanning technology for moving targets, clinical use of rescanning, development of beam gating and beam tracking and motion-dependent patient selection guidelines) [1] . Regardless of the exceptionally fast developments in this field, these ambitions have only been partly met today [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] .…”