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...

Physics-Guided Deep Learning for Volumetric-Modulated Arc Therapy Treatment Planning Quality Assurance

Treatment planning for radiation therapy is a complex process, as there are many machine parameters to determine for a treatment. To decrease the required labour and improve the plan quality, auto-planning systems have been developed, which can automatically generate high-quality treatment plans. These plans still have to be checked to ensure...

Conceptual probabilistic treatment planning approaches to deal with microscopic disease as an alternative to the Clinical Target Volume

Radiotherapy is one of the main treatment modalities available to treat cancer. Radiotherapy treatment plans are created based on CT scans of the patient. In such scans the macroscopic tumor is visible, but microscopic disease present in the surrounding tissue cannot be observed. To achieve an optimal clinical outcome, both the macroscopic and...

Treatment planning of intensity modulated proton therapy by using sparsity inducement for spot selection

In intensity modulated proton therapy (IMPT), patients are irradiated with small spots, that deliver a local dose to the tumor. The number of possible spots to choose from is virtually infinite, but practically limited, which requires a spot selection. This spot selection should result in an optimal treatment plan, i.e., to deliver a sufficient...

A physics guided neural network approach for dose prediction in automated radiation therapy treatment planning

Radiotherapy treatment planning is a complex and time consuming process prone to differences as result of choices of individual planners. Autoplanning systems have been introduced to both reduce the time consumption and to counteract the influence of individual planning choices. Although autoplanning generally increases performance of the...

Automated multi-criterial treatment planning for adaptive high-dose-rate brachytherapy for locally advanced cervical cancer

Purpose - To develop and evaluate a fast and automated multi-criterial treatment planning strategy for High-Dose-Rate (HDR) brachytherapy (BT) for patients with locally advanced cervical cancer. This automated strategy avoids suboptimal and slow manual treatment planning and results in reproducible and conformal treatment plans with a clinically...

Identifying the most relevant cost-functions for radiotherapy treatment planning with multicriteria optimisation

Cancer is a disease that one of every three people will get in The Netherlands. One of the treatment methods for this disease is radiotherapy. Approximately half of all cancer patients will get radiotherapy at some point of their treatment. During radiotherapy cancer cells are destroyed with ionizing radiation, but healthy cells get destroyed...