Hybrid proton planning combining spread-out Bragg peak beams with transmission beams to shorten field delivery times while maintaining plan quality

Background and purpose: Delivery times of Bragg-peak-based intensity-modulated proton therapy fields play an important role in patient throughput and comfort. Despite the associated exit dose, single-layer proton transmission beams benefit from sharper penumbras and are extremely fast to deliver. In...

Full description

Saved in:
Bibliographic Details
Main Authors: Roni Hytönen, Reynald Vanderstraeten, Wilko F.A.R. Verbakel
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Physics and Imaging in Radiation Oncology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405631625001149
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849317450833723392
author Roni Hytönen
Reynald Vanderstraeten
Wilko F.A.R. Verbakel
author_facet Roni Hytönen
Reynald Vanderstraeten
Wilko F.A.R. Verbakel
author_sort Roni Hytönen
collection DOAJ
description Background and purpose: Delivery times of Bragg-peak-based intensity-modulated proton therapy fields play an important role in patient throughput and comfort. Despite the associated exit dose, single-layer proton transmission beams benefit from sharper penumbras and are extremely fast to deliver. In this study, we investigated the trade-offs in field delivery times (FDT) and plan quality when using both field types. Materials and methods: Reference treatment plans were created for eight left-sided breast and ten oropharynx cancer patients using an in-house automatic iterative optimizer. Comparative hybrid plans were created for each case. For breast, different combinations of transmission and conventional beams were evaluated. For oropharynx, two of the three conventional beams were replaced with six transmission beams. Hybrid plans were evaluated by comparing the dose metrics and FDT against the reference plans. Results: Hybrid breast plans exhibited mean and maximum organ at risk (OAR) doses, and target dose homogeneity and conformity comparable to the reference plans, while their FDTs decreased by median (interquartile range) of 58 %/166 s (56–61 %). Compared to reference plans, hybrid oropharynx plans exhibited higher mean OAR dose especially to oral cavity (median of 34 Gy vs 31 Gy) and spinal cord (20 Gy vs 11 Gy), while FDTs decreased by 73 %/91 s (71–73 %). Discussion: Depending on the case, hybrid planning can significantly reduce total FDT with only limited impact on plan quality. The reduced total FDT can improve patient comfort, reduce overall duration of the treatment, and improve beam scheduling at multi-room centers.
format Article
id doaj-art-6e73e22ace35425993c6cabf9d7f64eb
institution Kabale University
issn 2405-6316
language English
publishDate 2025-07-01
publisher Elsevier
record_format Article
series Physics and Imaging in Radiation Oncology
spelling doaj-art-6e73e22ace35425993c6cabf9d7f64eb2025-08-20T03:51:13ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162025-07-013510080910.1016/j.phro.2025.100809Hybrid proton planning combining spread-out Bragg peak beams with transmission beams to shorten field delivery times while maintaining plan qualityRoni Hytönen0Reynald Vanderstraeten1Wilko F.A.R. Verbakel2Varian, a Siemens Healthineers Company, Helsinki, Finland; Corresponding author.Varian, a Siemens Healthineers Company, Brussels, BelgiumVarian, a Siemens Healthineers Company, Palo Alto, CA, United States; Amsterdam UMC, Department of Radiation Oncology, Amsterdam, the NetherlandsBackground and purpose: Delivery times of Bragg-peak-based intensity-modulated proton therapy fields play an important role in patient throughput and comfort. Despite the associated exit dose, single-layer proton transmission beams benefit from sharper penumbras and are extremely fast to deliver. In this study, we investigated the trade-offs in field delivery times (FDT) and plan quality when using both field types. Materials and methods: Reference treatment plans were created for eight left-sided breast and ten oropharynx cancer patients using an in-house automatic iterative optimizer. Comparative hybrid plans were created for each case. For breast, different combinations of transmission and conventional beams were evaluated. For oropharynx, two of the three conventional beams were replaced with six transmission beams. Hybrid plans were evaluated by comparing the dose metrics and FDT against the reference plans. Results: Hybrid breast plans exhibited mean and maximum organ at risk (OAR) doses, and target dose homogeneity and conformity comparable to the reference plans, while their FDTs decreased by median (interquartile range) of 58 %/166 s (56–61 %). Compared to reference plans, hybrid oropharynx plans exhibited higher mean OAR dose especially to oral cavity (median of 34 Gy vs 31 Gy) and spinal cord (20 Gy vs 11 Gy), while FDTs decreased by 73 %/91 s (71–73 %). Discussion: Depending on the case, hybrid planning can significantly reduce total FDT with only limited impact on plan quality. The reduced total FDT can improve patient comfort, reduce overall duration of the treatment, and improve beam scheduling at multi-room centers.http://www.sciencedirect.com/science/article/pii/S2405631625001149Proton therapyTreatment efficiencyHead and neck cancerLeft sided breast cancer
spellingShingle Roni Hytönen
Reynald Vanderstraeten
Wilko F.A.R. Verbakel
Hybrid proton planning combining spread-out Bragg peak beams with transmission beams to shorten field delivery times while maintaining plan quality
Physics and Imaging in Radiation Oncology
Proton therapy
Treatment efficiency
Head and neck cancer
Left sided breast cancer
title Hybrid proton planning combining spread-out Bragg peak beams with transmission beams to shorten field delivery times while maintaining plan quality
title_full Hybrid proton planning combining spread-out Bragg peak beams with transmission beams to shorten field delivery times while maintaining plan quality
title_fullStr Hybrid proton planning combining spread-out Bragg peak beams with transmission beams to shorten field delivery times while maintaining plan quality
title_full_unstemmed Hybrid proton planning combining spread-out Bragg peak beams with transmission beams to shorten field delivery times while maintaining plan quality
title_short Hybrid proton planning combining spread-out Bragg peak beams with transmission beams to shorten field delivery times while maintaining plan quality
title_sort hybrid proton planning combining spread out bragg peak beams with transmission beams to shorten field delivery times while maintaining plan quality
topic Proton therapy
Treatment efficiency
Head and neck cancer
Left sided breast cancer
url http://www.sciencedirect.com/science/article/pii/S2405631625001149
work_keys_str_mv AT ronihytonen hybridprotonplanningcombiningspreadoutbraggpeakbeamswithtransmissionbeamstoshortenfielddeliverytimeswhilemaintainingplanquality
AT reynaldvanderstraeten hybridprotonplanningcombiningspreadoutbraggpeakbeamswithtransmissionbeamstoshortenfielddeliverytimeswhilemaintainingplanquality
AT wilkofarverbakel hybridprotonplanningcombiningspreadoutbraggpeakbeamswithtransmissionbeamstoshortenfielddeliverytimeswhilemaintainingplanquality