Abstract

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Title:: Applications of robust optimization in intensity modulated proton therapy

Author(s):: WANG Xianliang; LI Jie; WANG Pei; Center of Radiation Therapy/Sichuan Cancer Hospital Sichuan Provincical Key Laboratory of Radiation Oncology, Chengdu 610041, China

Keywords:: Keywords: intensity modulated proton therapy robust optimization robustness evaluation review

Abstract:: Abstract: The intensity modulated proton therapy (IMPT) process is susceptible to factors such as range uncertainties, setup uncertainties and anatomical changes. The robust optimization of IMPT is a method to increase the robustness of treatment plan by taking these uncertainties into consideration in the process of optimization, which is widely used in clinical practice. There are four methods for robust optimization: (1) probability method (2) worst dose method (3) adding constraints (4) multiple CT optimization. This paper reviews the principles, advantages and disadvantages of these four methods and their clinical application, and it also introduces the evaluation methods for robustness. Although the dose volume histogram (DVH) bands is the most commonly used method to evaluate the plan robustness, DVH bands cannot reflect the robustness of IMPT plan with anatomical changes. Therefore, it is urgent to establish a simple and widely accepted robustness evaluation method to facilitate the comparison and evaluation of IMPT plans.