TH-A-BRE-01: The Status of Intensity Modulated Proton and Ion Therapy

Authors


Abstract

IMRT with photons has become a radiation therapy standard of care for many cancer treatment sites. The situation is quite different with intensity modulated particle (protons and ion) radiation therapy (IMPT). With the rapid development of beam scanning techniques and many of the newer proton facilities exclusively offering active beam scanning as their radiation delivery technique, it is timely to give an update on the status and challenges of IMPT. The leading principle in IMPT is to aim at the target from several, not necessarily coplanar, directions with multiple pencil beams that are modulated in their intensity and adjusted in their energy such that a desired dose distribution or, more generally, a desired bio-effective dose distribution is achieved. Different from low-LET photons, the varying relative biological effectiveness (RBE) along the beam path adds an additional dimension to the treatment planning process and will require biophysical modeling at least for carbon ion therapy. IMPT involves computationally challenging tasks, yet it needs to be very fast in order to be clinically relevant. To make IMPT computationally tractable, robust and efficient optimization methods are required. Lastly, IMPT planning is very sensitive to accurate knowledge of relative stopping and scattering powers of the intervening tissues as well as intra- and inter-fraction motion. Robust planning methods are being developed in order to obtain IMPT plans that are less sensitive against such uncertainties. This therapy symposium will present an update on the current status and emerging developments of IMPT from the medical physics perspective.

Learning Objectives:

  • 1.Become familiar with current delivery techniques for IMPT and their limitations.
  • 2.Understand the basics of dose calculational algorithms and commissioning of IMPT.
  • 3.Learn how to assess the accuracy of planning and delivery of IMPT treatments.
  • 4.Get an overview of currently used and emerging optimization techniques.
  • 5.Learn about the pro or contra arguments for using IMPT for moving targets.

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