A survey of practice patterns for real-time intrafractional motion-management in particle therapy

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

“…The target coverage might be further reduced due to intrafractional motions of the organs and the intestinal gas during irradiation. There are several recent studies dealing with this topic [43] , [44] . Third, the robustness evaluation of the stomach and duodenum was conducted, considering only the range uncertainty, without considering motions of the targets and organs.…”

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).…”

“…While the first addressed the advantages and cost-effectiveness of PT, the second focused on practical aspects of 4D thoracic treatments and technical requirements. The clinical implementation of these recommendations and guidelines ( Table 1 ) was summarised in the most recent surveys on pattern of practice approaching harmonisation of 4D treatment approaches [8] , [9] , [140] . It has been well understood that respiratory motion management is essential for treatment sites located in the thorax and abdomen with breath-hold gating (for (left-sided) breast cancer) widely implemented in conventional photon therapy.…”

“…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] .…”

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

“…This paper focuses on APT for interfractional anatomical changes. Real-time respiratory motion management is addressed in a parallel paper [29] . The following APT strategies were considered in the survey: offline ad-hoc adaptation due to e.g.…”