ESTRO 2024 - Abstract Book

S4724

Physics - Optimisation, algorithms and applications for ion beam treatment planning

ESTR0 2024

Figure 1: Dose distributions of a proton plan optimized on the diastolic phase only (top) and on the diastolic and systolic phase (bottom).

Conclusion:

Cardiac-gated imaging should be mandatory for the delineation of the target and OARs in different phases. Proton plans generally improve the mean and maximum dose to cardiac structures, given a comparable target coverage. Still, a proton treatment is not an obvious choice, as well as the preference for a cardiac-gated modality: we recommend evaluating each case on a patient-specific basis. The potential benefit of treating with protons instead of photons for a specific cardiac structure should be considered, but, at the same time, other aspects should be discussed with the clinician, such as the longer treatment time for proton delivery, maybe not bearable for the patient, and potential uncertainties that could affect the proton dose distribution more importantly than the photon one. Moreover, the relevance of certain cardiac substructures with respect to others is still to be properly investigated.

Keywords: arrhythmia, proton therapy, vmat

References: