Pencil beam scanning proton lattice radiotherapy: single-field versus multi-field optimization
Shouyi Wei et al.
The article investigates optimization strategies for proton lattice radiotherapy using pencil beam scanning (PBS). Lattice radiotherapy is an innovative treatment approach in which high radiation dose regions, known as vertices, are delivered inside large tumors while surrounding tumor tissue receives lower doses. This spatially fractionated technique aims to improve tumor control while reducing toxicity. The study compares single-field optimization (SFO) and multi-field optimization (MFO) methods in proton PBS lattice radiotherapy to determine which strategy provides better dose distribution and robustness.
During the development of the study, treatment plans were generated for patients with large tumors using both SFO and MFO techniques. Researchers evaluated target coverage, dose conformity, sparing of organs at risk, and plan robustness under uncertainties such as setup errors and range variations. The analysis focused particularly on the ability of each optimization method to maintain the intended lattice dose pattern while preserving treatment safety and precision.
The results showed that both optimization approaches were capable of creating clinically feasible proton lattice radiotherapy plans. However, MFO generally achieved superior dose conformity and improved sparing of surrounding healthy tissues compared with SFO. MFO also provided greater flexibility in shaping high-dose vertices within the tumor. Nevertheless, SFO demonstrated advantages in robustness, as it was less sensitive to setup and range uncertainties. This trade-off highlighted the balance between plan quality and treatment stability.
In conclusion, the study suggests that both SFO and MFO are viable approaches for proton lattice radiotherapy, but their selection should depend on clinical priorities. MFO may offer better dosimetric performance, while SFO may provide greater robustness and reliability in daily treatment delivery.
Published by Frontieres in Oncology
