A PROSPECTIVE CLINICAL TRIAL OF UPRIGHT IMAGE-GUIDED PROTON THERAPY FOR THORACIC RE-IRRADIATION: INTERIM RESULTS

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Results: Protocol compliance was achieved for all heart and total-lung metrics on the pCT.For the heart, when comparing accumulated delivered doses with the planned doses, average deviations were modest: 4.5% (MHD), 9.2% (V40Gy), 6.2% (V25Gy).For the scaled per-fraction doses, the average median boxplot spans were narrow: 1.5% (MHD), 1.2% (V40Gy), 1.6% (V25Gy), highlighting stable day-to-day delivery with outliers remaining within constraints (Figure 1).Plan-delivery deviations for the lungs were small: 2.2% (MLD), 3.8% (V20Gy), 2.8% (V5Gy), and day-to-day variation remained limited, with median relative spans of 0.4% (MLD), 0.5% (V20Gy), 1% (V5Gy) (Figure 2).Conclusions: Using daily CBCT, all 27 PROTECT patients met protocol constraints for cardiac and pulmonary dose at planning and throughout the actual delivery.Limited day-to-day variation indicates that per-fraction doses were generally close to the planned doses, yielding minimal deviation in accumulated doses.

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