JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
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Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 2. P. 23–32
DOI: 10.12737/article_5ca5e2677a1a06.60363700
V.A. Klimanov1,2, A.S. Samoylov2, A.E. Gadzhinov3, Ya.A. Peshkin3
Physics of Proton Therapy Treatment Planning
1. National Research Nuclear University MEPhI, Moscow, Russia, E-mail:
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;
2. A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia;
3. Federal High-Tech Center for Medical Radiology of Federal Medical Biological Agency, Dimitrovgrad, Russia
V.A. Klimanov – Leading Researcher, Dr. Sci. Phys.-Math., Prof.;
A.S. Samoylov – Director General, Dr. Sci. Med., Prof. RAS;
A.E. Gadzhinov – radiotherapist;
Ya.A. Peshkin – radiologist
Abstract
The most important stage of radiation therapy of oncological diseases is the planning of radiation treatment. In this work, this complex process in relation to proton therapy is proposed to be divided into medical and physical planning. In conventional therapy with photons and electrons, the latter is usually called dosimetric planning, however, when applied to proton radiation therapy, this stage involves a significantly wider range of tasks related to the modification and scanning of the proton beam, spreading and compensation of ranges, taking into account when planning for uncertainties and finiteness of proton ranges, a decrease in the contribution to the dose of secondary neutrons, the creation of error-tolerant optimization algorithms for dosimetric plans, and, finally, a precision calculation of dose distributions. The paper discusses the main stages and problems of physical planning of proton radiation therapy. Particular attention is paid to the formation of an extended high-dose region (extended Bragg peak) using the beam scattering method and scanning method, and to the algorithms for calculating the dose distributions created by protons in the scattering and beam scanning systems. The most detailed consideration is given to different versions of the proton pencil beam method, which allows to increase the dose calculation accuracy and take into account the transverse scattering and fluctuations in proton energy losses, especially at the end of the path (halo effect), analytical and numerical methods. Scanning are divided into three main technologies: homogeneous scanning, single field uniform dose (SFUD), multi-field uniform dose (MFUD), often called intensity modulated proton therapy (IMPT). Actual accounting problems are considered when planning the irradiation of the movement of organs, and uncertainties in determining path lengths and optimization of irradiation plans. In particular features, problems and modern approaches to the optimization of dosimetry plans of proton radiation therapy are discussed. It is noted that one of the most promising practical solutions for the uncertainty management in determining the path lengths of protons in optimization is to include possible errors in the objective function of the optimization algorithm. This technique ensures that an optimized irradiation plan will more reliably protect normal tissues and critical organs adjacent to the irradiation target from overexposure.
Key words: radiotherapy, protons, proton scattering, range modulation, pencil beam, dose, organ movement, range uncertainty, planning optimization
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For citation: Chernyaev AP, Klenov GI, Bushmanov AYu, Pryanichnikov AA, Belikhin MA, Lykova EN. Proton Accelerators for Radiation Therapy. Medical Radiology and Radiation Safety. 2019;64(2):11-22. (Russian).
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