Treatment Planning for Protons: An Essay

  • Hanne Kooy


The first proton radiotherapy patient was treated in 1957 at the Berkeley Radiation Laboratory. At the Harvard Cyclotron Laboratory, treatments commenced shortly after in the early 1960s under the direction of the Massachusetts General Hospital neurosurgeon Dr. Raymond Kjellberg. Neurosurgeons were well equipped to use the precision of proton beams without the availability of 3D imaging technologies such as CT. Their appreciation of the 3D cranial anatomy projected on X-rays sufficed to treat neoplasms such as pituitary abnormalities and arterial venous malformations. Both Dr. Kjellberg in Boston and Dr. Leksell in Stockholm pioneered the use of protons in the cranial anatomy. Dr. Kjellberg’s program, however, had ready access to the proton beam at the HCL (Fig. 7.1). Dr. Leksell’s program did not have ready access which led to the invention of the Leksell Gamma Knife as an alternative therapeutic system for stereotactic radiosurgery. Protons were thus the first modality used in cranial stereotactic radiosurgery, while the Gamma Knife made cranial stereotactic radiosurgery a standard modality.


Planning Target Volume Treatment Planning System Proton Radiotherapy Pencil Beam Planning Target Volume Margin 
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  1. 1.
    Engelsman M, Rietzel E, Kooy HM. Four-dimensional proton treatment planning for lung tumors. Int J Radiat Oncol Biol Phys. 2006;64:1589–95.CrossRefPubMedGoogle Scholar
  2. 2.
    Bohoslavsky R, Witte MG, Janssen TM, van Herk M. Probabilistic objective functions for margin-less IMRT planning. Phys Med Biol. 2013;58:3563–80.CrossRefPubMedGoogle Scholar
  3. 3.
    Paganetti H. Range uncertainties in proton therapy and the role of Monte Carlo simulations. Phys Med Biol. 2013;2012(57):99–117.Google Scholar
  4. 4.
    Chen W, Unkelbach J, Trofimov A, Madden T, Kooy H, Bortfeld T, Craft D. Including robustness in multi-criteria optimization for intensity-modulated proton therapy. Phys Med Biol. 2012;57:591–608.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Halabi T, Craft D, Bortfeld TR. Dose–volume objectives in multi-criteria optimization. Phys Med Biol. 2006;51:3809–18.CrossRefPubMedGoogle Scholar
  6. 6.
    DICOM Standards Committee, Working Group 7. Radiation therapy. Supplement 147: Second Generation Radiotherapy. Revision 42, March 28, 2014Google Scholar
  7. 7.
    van de Water S, Kraan AC, et al. Improved efficiency of multi-criteria IMPT treatment planning using iterative resampling of randomly placed pencil beams. Phys Med Biol. 2013;58:6969–83.CrossRefPubMedGoogle Scholar
  8. 8.
    Monz M, Kufer KH, Bortfeld TR, Thieke C. Pareto navigation—algorithmic foundation of interactive multi-criteria IMRT planning. Phys Med Biol. 2008;53:985–98.CrossRefPubMedGoogle Scholar
  9. 9.
    Kraan AC, van de Water S, et al. Dose uncertainties in IMPT for oropharyngeal cancer in the presence of anatomical, range, and setup errors. Int J Radiat Oncol Biol Phys. 2013;87:888–96.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Department of Radiation OncologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

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