{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:54:26Z","timestamp":1785304466349,"version":"3.55.0"},"reference-count":47,"publisher":"IOP Publishing","issue":"7","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"name":"Varian, a Siemens Healthineers Company","award":["2018007"],"award-info":[{"award-number":["2018007"]}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Phys. Med. Biol."],"published-print":{"date-parts":[[2024,4,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    . In head-and-neck cancer intensity modulated proton therapy, adaptive radiotherapy is currently restricted to offline re-planning, mitigating the effect of slow changes in patient anatomies. Daily online adaptations can potentially improve dosimetry. Here, a new, fully automated online re-optimization strategy is presented. In a retrospective study, this online re-optimization approach was compared to our trigger-based offline re-planning (offline\n                    <jats:sub>TB<\/jats:sub>\n                    re-planning) schedule, including extensive robustness analyses.\n                    <jats:italic>Approach<\/jats:italic>\n                    . The online re-optimization method employs automated multi-criterial re-optimization, using robust optimization with 1 mm setup-robustness settings (in contrast to 3 mm for offline\n                    <jats:sub>TB<\/jats:sub>\n                    re-planning). Hard planning constraints and spot addition are used to enforce adequate target coverage, avoid prohibitively large maximum doses and minimize organ-at-risk doses. For 67 repeat-CTs from 15 patients, fraction doses of the two strategies were compared for the CTVs and organs-at-risk. Per repeat-CT, 10.000 fractions with different setup and range robustness settings were simulated using polynomial chaos expansion for fast and accurate dose calculations.\n                    <jats:italic>Main results<\/jats:italic>\n                    . For 14\/67 repeat-CTs, offline\n                    <jats:sub>TB<\/jats:sub>\n                    re-planning resulted in &lt;50% probability of\n                    <jats:italic>D<\/jats:italic>\n                    <jats:sub>98%<\/jats:sub>\n                    \u2265 95% of the prescribed dose (\n                    <jats:italic>D<\/jats:italic>\n                    <jats:sub>pres<\/jats:sub>\n                    ) in one or both CTVs, which never happened with online re-optimization. With offline\n                    <jats:sub>TB<\/jats:sub>\n                    re-planning, eight repeat-CTs had zero probability of obtaining\n                    <jats:italic>D<\/jats:italic>\n                    <jats:sub>98%<\/jats:sub>\n                    \u2265 95%\n                    <jats:italic>D<\/jats:italic>\n                    <jats:sub>pres<\/jats:sub>\n                    for CTV\n                    <jats:sub>7000<\/jats:sub>\n                    , while the minimum probability with online re-optimization was 81%. Risks of xerostomia and dysphagia grade \u2265 II were reduced by 3.5 \u00b1 1.7 and 3.9 \u00b1 2.8 percentage point [mean \u00b1 SD] (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 10\n                    <jats:sup>\u22125<\/jats:sup>\n                    for both). In online re-optimization, adjustment of spot configuration followed by spot-intensity re-optimization took 3.4 min on average.\n                    <jats:italic>Significance<\/jats:italic>\n                    . The fast online re-optimization strategy always prevented substantial losses of target coverage caused by day-to-day anatomical variations, as opposed to the clinical trigger-based offline re-planning schedule. On top of this, online re-optimization could be performed with smaller setup robustness settings, contributing to improved organs-at-risk sparing.\n                  <\/jats:p>","DOI":"10.1088\/1361-6560\/ad2a98","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T17:24:15Z","timestamp":1708363455000},"page":"075007","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["A fast and robust constraint-based online re-optimization approach for automated online adaptive intensity modulated proton therapy in head and neck cancer"],"prefix":"10.1088","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0988-0345","authenticated-orcid":false,"given":"Michelle","family":"Oud","sequence":"first","affiliation":[{"name":"University Medical Center"},{"name":"HollandPTC, Department of Medical Physics & Informatics, Delft,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8954-4554","authenticated-orcid":false,"given":"Sebastiaan","family":"Breedveld","sequence":"additional","affiliation":[{"name":"University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4598-7430","authenticated-orcid":false,"given":"Jes\u00fas","family":"Rojo-Santiago","sequence":"additional","affiliation":[{"name":"University Medical Center"},{"name":"HollandPTC, Department of Medical Physics & Informatics, Delft,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5880-6814","authenticated-orcid":false,"given":"Marta Krystyna","family":"Gi\u017cy\u0144ska","sequence":"additional","affiliation":[{"name":"HollandPTC, Department of Medical Physics & Informatics, Delft,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1346-2277","authenticated-orcid":false,"given":"Michiel","family":"Kroesen","sequence":"additional","affiliation":[{"name":"University Medical Center"},{"name":"HollandPTC, Department of Radiation Oncology, Delft,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Habraken","sequence":"additional","affiliation":[{"name":"University Medical Center"},{"name":"HollandPTC, Department of Medical Physics & Informatics, Delft,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0975-4226","authenticated-orcid":false,"given":"Zolt\u00e1n","family":"Perk\u00f3","sequence":"additional","affiliation":[{"name":"Delft University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1647-0528","authenticated-orcid":false,"given":"Ben","family":"Heijmen","sequence":"additional","affiliation":[{"name":"University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4264-9903","authenticated-orcid":false,"given":"Mischa","family":"Hoogeman","sequence":"additional","affiliation":[{"name":"University Medical Center"},{"name":"HollandPTC, Department of Medical Physics & Informatics, Delft,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"pmbad2a98bib1","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1080\/0284186X.2019.1629017","type":"journal-article","article-title":"Inter-observer variability in target delineation increases during adaptive treatment of head-and-neck and lung cancer","volume":"58","author":"Apolle","year":"2019","journal-title":"Acta Oncol."},{"key":"pmbad2a98bib2","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/aaba8c","type":"journal-article","article-title":"Feasibility of online IMPT adaptation using fast, automatic and robust dose restoration","volume":"63","author":"Bernatowicz","year":"2018","journal-title":"Phys. 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