Abstract
The popularity of particle radiotherapy has grown exponentially over recent years owing to the marked advantage of the depth–dose curve and its unique biological property. However, particle therapy is sensitive to changes in anatomical structure, and the dose distribution may deteriorate. In particle therapy, robust beam angle selection plays a crucial role in mitigating inter- and intrafractional variation, including daily patient setup uncertainties and tumor motion. With the development of a rotating gantry, angle optimization has gained increasing attention. Currently, several studies use the variation in the water equivalent thickness to quantify anatomical changes during treatment. This method seems helpful in determining better beam angles and improving the robustness of planning. Therefore, this review will discuss and summarize the robust beam angles at different tumor sites in particle radiotherapy.
Highlights
Radiotherapy (RT) aims to deliver the prescription dose to the target lesion while causing minimal damage to the surrounding normal tissues
A previous study [35] found that particle therapy plans with respiratory management taking 4D-CT results into consideration effectively mitigate uncertainties of respiratory motion, dose distributions in the anterior and left direction beams are still affected by intra-fractional deviations (Figure 5), and the clinical target volume (CTV) D95% was degraded from 98.2% to 88.3%
Intracranial tumors are an important target of particle radiotherapy because the physical property of particle therapy allows the suppression of the dose to vital organs, especially the normal brain
Summary
Radiotherapy (RT) aims to deliver the prescription dose to the target lesion while causing minimal damage to the surrounding normal tissues. The dose distribution deposited by the particle (proton and carbon) beam exponentially increases to a sharp maximum at the end of the trajectory This is known as the Bragg peak [1, 3]. With the wide application of the rotating gantry in treatment in recent years, research on angle optimization has received more attention than previously (Figure 1), and the concept of robust beam arrangement is emerging. This is important to enable selection of beam angles that can avoid the uncertainties of anatomical changes along the ray path to achieve satisfactory dose distribution. All the descriptions of the angle in this article refer to Figure 2
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