Particle Therapy 2017

‹#› Practical considerations for lung planning… • 4D simulation with PET/CT fusion: Limit patient acceptance to < 1 cm respiratory tumor excursion • ITV • Expand ITV + 7mm= CTV • CTV + 5mm= PTV • Typically use 3 beams (can treat 2 fields/day) • Limit 1/3 of the beams to range into critical structure (cord/esophagus/ heart etc) <1cm Inclusion criteria has been largely accepted by proton centers using pencil beam scanning exclusively Majority of centers in the US treat without or minimal motion management Issue of QACT for Re-Planning without clear guidelines: Dependent on institution and imaging capabilities and practicality