Simulation of 4-dimensional tumor motion and the assessment of the interplay effect in pencil beam scanning proton beam therapy

Introduction Holland PTC (Delft, The Netherlands) is an independent outpatient clinic where ten different types of cancer are treated with Pencil Beam Scanning (PBS). Some of these cancer types are situated in the thoracic region and therefore exposed to breathing motion. The interplay between the dynamic pencil beam delivered in PBS and the...

Definitive treatment for early-stage breast cancer with FLASH proton therapy: Dosimetric feasibility and optimization with intensity-modulated ridge filtered beams and toxicity-model endpoints

The aim of this thesis is to study the dosimetric feasibility of FLASH proton therapy for early-stage breast cancer patients. The biological effect of FLASH is seen under ultra-high dose-rates conditions and is beneficial in the damage to healthy tissue. The FLASH effect could enable the clinical feasibility of definitive radiotherapy for low...

Impact of Variations in Patient and Beam Parameters on Proton Therapy using Pencil Beam Scanning technique

Pencil beam scanning is a technique used in the proton therapy. This technique makes use of a thin beam which can irradiate each spot at millimetre precision. It is a very promising technique, especially for more radiation sensitive areas, e.g. lung carcinogenesis, as it can spare more healthy surrounding tissue compared to conventional...

FLASH optimisation in clinical IMPT treatment planning: optimisation and evaluation of stereotactic lung treatment plans with proton transmission beams

Radiotherapy (RT) is an important modality in treatment against cancer. Developments in this modality are necessary for improvement of patient complications and survival. Aside from fractionation and precise irradiation, FLASH radiotherapy could be a third way to significantly increase the therapeutic window of radiotherapy.The FLASH effect is a...

Irregular breathing in proton therapy: The effect of irregular breathing on the interplay effect in pencil beam scanning proton therapy

Pencil beam scanning is becoming a more common treatment modality. However, its ability to deal with moving targets is known to be limited, as beam motion and target motion can reinforce each other, deteriorating the planned dose distribution in what is called the interplay effect. Literature concerning breathing motion usually investigates...