Online adaptive planning methods for intensity-modulated radiotherapy

Abstract

Online adaptive radiation therapy aims at adapting a patient’s treatment plan to their current anatomy to account for inter-fraction variations before daily treatment delivery. As this process needs to be accomplished while the patient is immobilized on the treatment couch, it requires time-efficient adaptive planning methods to generate a quality daily treatment plan rapidly. The conventional planning methods do not meet the time requirement of online adaptive radiation therapy because they often involve excessive human intervention, significantly prolonging the planning phase. This article reviews the planning strategies employed by current commercial online adaptive radiation therapy systems, research on online adaptive planning, and artificial intelligence’s potential application to online adaptive planning.

Guía para el control de calidad y seguridad de los sistemas de planificación y planes de tratamiento de radioterapia externa

“…No obstante, existe cierto debate en torno a la obligatoriedad de verificar experimentalmente todos los planes con modulación de intensidad debido a la falta de sensibilidad de las verificaciones pre-tratamiento y al creciente uso de estas técnicas, que en muchos centros ya constituyen un estándar de tratamiento. 32,87 Además, en algunos centros ya se usa la radioterapia adaptativa online o en tiempo real, en la que los tratamientos se reoptimizan y calculan una vez el paciente está en posición de tratamiento, 287 no siendo factible en estos casos la realización de medidas experimentales pre-tratamiento.…”

A fast and robust constraint-based online re-optimization approach for automated online adaptive intensity modulated proton therapy in head and neck cancer

“…Daily online plan adaptation has the potential to reduce dose degradation caused by inter-fraction anatomy and position variability (Bertholet et al 2020, Qiu et al 2023, Trnkova et al 2023. This is particularly relevant for intensity modulated proton therapy (IMPT), where the delivered dose is substantially more sensitive to these variations.…”

Surveying the clinical practice of treatment adaptation and motion management in particle therapy

“…While several review papers on real-time intrafractional respiratory motion management (RRMM) and adaptive particle therapy (APT) for interfractional changes were published within the last decade [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , the recently published survey papers by Zhang and Trnkova and their co-workers are the first of their kind [14] , [15] . Following up on a similar initiative addressing photon-based radiotherapy [16] , [17] , these two surveys report on the clinical practice and associated barriers of 70 particle therapy centres (68 operating) from 17 countries [14] , [15] .…”