Principles of intensity-modulated proton therapy treatment planning

The purpose of this chapter is to provide the reader with hands-on knowledge of the most important elements of treatment planning for intensity-modulated proton therapy (IMPT), including clinical scenarios, sources of uncertainties, robust evaluation methods, robust optimization methods, beam angle selection, spot energy selection, spot spacing selection, and knowledge-based IMPT planning. We selected four clinical disease sites, including prostate, prostate with pelvic lymph node involvement, lung, and head and neck (HN) to show how the MD Anderson team develops treatment plans for those sites. For prostate sites, we focus on potential new beam angles to improve treatment planning. For prostate with pelvic lymph node involvement, we focus on the robust optimization workflow. For lung planning, we focus on motion management. For HN sites, we focus on the adaptive treatment workflow.