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Open AccessTechnical Note
Cancers 2018, 10(1), 7;

Clinical Implementation of Robust Optimization for Craniospinal Irradiation

Department of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA
Author to whom correspondence should be addressed.
Received: 25 October 2017 / Revised: 15 December 2017 / Accepted: 26 December 2017 / Published: 3 January 2018
(This article belongs to the Special Issue Proton and Carbon Ion Therapy)
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With robust optimization for spot scanning proton therapy now commercially available, the ability exists to account for setup, range, and interfield uncertainties during optimization. Robust optimization is particularly beneficial for craniospinal irradiation (CSI) where the large target volume lends itself to larger setup uncertainties and the need for robust match lines can all be handled with the uncertainty parameters found inside the optimizer. Suggested robust optimization settings, parameters, and image guidance for CSI patients using proton therapy spot scanning are provided. Useful structures are defined and described. Suggestions are given for perturbations to be entered into the optimizer in order to achieve a plan that provides robust target volume coverage and critical structure sparing as well as a robust match line. Interfield offset effects, a concern when using multifield optimization, can also be addressed within the robust optimizer. A robust optimizer can successfully be employed to produce robust match lines, target volume coverage, and critical structure sparing under specified uncertainties. The robust optimizer can also be used to reduce effects arising from interfield uncertainties. Using robust optimization, a plan robust against setup, range, and interfield uncertainties for craniospinal treatments can be created. Utilizing robust optimization allows one to ensure critical structures are spared and target volumes are covered under the desired uncertainty parameters. View Full-Text
Keywords: craniospinal irradiation; CSI; robust optimization; proton spot scanning craniospinal irradiation; CSI; robust optimization; proton spot scanning

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Tasson, A.; Laack, N.N.; Beltran, C. Clinical Implementation of Robust Optimization for Craniospinal Irradiation. Cancers 2018, 10, 7.

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