{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:36:33Z","timestamp":1792002993384,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>The inherent uncertainties associated with proton therapy (PT) may present a challenge to the optimal clinical utilization of this radiotherapy modality. The possibility to overcome the uncertainties associated with temporal fluctuations in some parameters of the PT system by selecting an additional clinical target volume to planning parget volume\u00a0(CTV\u2010PTV) margin or by modifying the planning approach was suggested. The objective of this work was to verify the sufficiency of the calculated additional margin for overcoming beam positioning uncertainties in spot\u2010scanning PT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Treatment plans for eight patients were calculated using two methods (robust optimization and PTV\u2010based approaches) and evaluated with regard to dose\u2010volume histogram (DVH)\u2010based dosimetric metrics. The robustness of each plan was evaluated under six scenarios in linear directions \u00b14\u00a0mm and two scenarios with a \u00b13.5% range uncertainty. A comparison between robust optimization and PTV\u2010based approaches was performed in the context of additional 1\u2010mm setup uncertainty associated with facility\u2010specific beam uncertainties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No statistically significant difference was identified between the initial plans of the PTV\u2010based and robust approaches with regard to investigated dosimetric metrics. But robust optimization shows better results in comparison to PTV approach in majority of investigated scenarios. CTV was fully encompassed by the 100% dose in the plans created using the robust optimization approach. The Robust approach demonstrated superior dose conformity to the CTV, both for the 100% and 95% prescribed doses. Although both the PTV and Robust approaches permitted homogeneity in all scenarios, the superiority of the Robust approach was evident.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>It is necessary to consider the facility\u2010specific beam uncertainty as additional margin during treatment planning in PT. It was demonstrated that the robust optimization approach is an effective method for eliminating beam\u2010related facility\u2010specific uncertainties order of 1\u00a0mm in comparison to the PTV planning approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70355","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T04:05:37Z","timestamp":1763179537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Benefits of robust optimization in comparison with PTV\u2010based planning approach to overcome beam positioning uncertainties in spot\u2010scanning proton therapy"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-7681","authenticated-orcid":false,"given":"Vasilii A.","family":"Kiselev","sequence":"first","affiliation":[{"name":"FSBI \"Federal Scientific Clinical Center for Medical Radiology and Oncology\" of FMBA of Russia  Dimitrovgrad Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5250-046X","authenticated-orcid":false,"given":"Aleksander P.","family":"Chernyaev","sequence":"additional","affiliation":[{"name":"Lomonosov Moscow State University  Moscow Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-2336","authenticated-orcid":false,"given":"Mikhail A.","family":"Belikhin","sequence":"additional","affiliation":[{"name":"Dmitry Rogachev National Medical Research Center of Pediatric Hematology Oncology and Immunology  Moscow Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3520-5746","authenticated-orcid":false,"given":"Rail R.","family":"Zamaltdinov","sequence":"additional","affiliation":[{"name":"FSBI \"Federal Scientific Clinical Center for Medical Radiology and Oncology\" of FMBA of Russia  Dimitrovgrad Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2905-3946","authenticated-orcid":false,"given":"Sergei A.","family":"Vladimirkin","sequence":"additional","affiliation":[{"name":"FSBI \"Federal Scientific Clinical Center for Medical Radiology and Oncology\" of FMBA of Russia  Dimitrovgrad Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2500-158X","authenticated-orcid":false,"given":"Sergei E.","family":"Gritsenko","sequence":"additional","affiliation":[{"name":"FSBI \"Federal Scientific Clinical Center for Medical Radiology and Oncology\" of FMBA of Russia  Dimitrovgrad Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2537-6157","authenticated-orcid":false,"given":"Aleksey V.","family":"Nechesnyuk","sequence":"additional","affiliation":[{"name":"Dmitry Rogachev National Medical 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