EURO 2024 Copenhagen
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3295. Motion-adaptive optimization for proton therapy with pencil beam scanning

Invited abstract in session TA-10: Radiotherapy and chemotherapy planning, stream OR in Health Services (ORAHS).

Tuesday, 8:30-10:00
Room: 11 (building: 116)

Authors (first author is the speaker)

1. Ivar Bengtsson
Mathematics, KTH Royal Institute of Technology
2. Anders Forsgren
Department of Mathematics, KTH Royal Institute of Technology
3. Albin Fredriksson
RaySearch Laboratories AB

Abstract

Pencil beam scanning (PBS) is an advanced technique for treating cancer with proton radiation. It can deliver radiation with great precision, allowing the tumor to be targeted with less harm to healthy tissue. However, the precision comes with a large sensitivity to uncertainty of the patient’s position and anatomy. Whilst robust optimization has proven successful in managing positional uncertainty in PBS treatments, treatment of motion-subjected tumors due to variational anatomy, such as those in the lungs, may benefit from a motion-adaptive treatment planning approach.

In this work, we build on previous attempts to explicitly plan with respect to the respiratory patterns of lung patients, as well as motion-adaptive optimization proposed for photon treatments, to propose a motion-adaptive control strategy for PBS. During the delivery of the treatment, the patient’s breathing motion is tracked and predicted into the future. The predicted motion is then used to re-optimize the treatment over a receding horizon.

We show that the motion-adaptive strategy is superior to robust optimization in terms of both consistently treating the target with sufficient radiation and sparing nearby healthy tissue. Although much work remains to demonstrate the feasibility of implementing the proposed strategy in real-time, our results demonstrate the benefits of successfully implementing a motion-adaptive strategy, further realizing the precision advantage of proton therapy with PBS.

Keywords

Status: accepted

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