Lung cancer remains the leading cause of cancer death in North America and is one of the major indications for proton therapy. Proton beams provide a superior dose distribution due to their finite ranges, but where they stop in the tissue is very sensitive to anatomical change. To ensure optimal target coverage and normal tissue sparing in the presence of geometrical variations, such as tumor shrinkage and other anatomical changes, adaptive planning is necessary in proton therapy of lung cancer. The objective of the chapter is to illustrate the rationale, process, and strategies in adaptive lung cancer treatment using uniform scanning proton beams. In addition, practical considerations for adaptive proton planning are discussed, such as software limitations, the associated costs and risks, and the criteria on whether and how to adapt a plan.
Part of the book: Radiotherapy