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@MASTERSTHESIS{Baltazar:177455,
      author       = {F. Baltazar$^*$},
      title        = {{FLASH} optimization for multi-beam proton therapy},
      school       = {IST, University of Lisbon},
      type         = {Masterarbeit},
      reportid     = {DKFZ-2021-02547},
      year         = {2021},
      note         = {Corresponding author: J. Seco; Masterarbeit, IST,
                      University of Lisbon, 2021},
      abstract     = {Radiotherapy is a balancing act between maximizing tumor
                      control and minimizing radiation-inducedtoxicity. FLASH
                      radiotherapy has shown promising results in reducing the
                      healthy tissue damage for thesame level of tumor toxicity.
                      This work aims at the development of a treatment plan
                      strategy for FLASHradiotherapy, considering multiple proton
                      beams. In order to allow that, we must divide the target
                      indifferent regions. Each region is irradiated with either
                      FLASH or conventional beams, and then webring the different
                      irradiated regions all together in an optimized stitching
                      geometry. Different tools andmethods of incorporating dose
                      rate into treatment planning were explored. Particularly,
                      both sequentialand simultaneous dose and dose rate
                      optimization techniques were studied, and specific treatment
                      planswere implemented. Results showed the potential of the
                      stitching geometry in accommodating multipleFLASH beams in
                      homogeneous target irradiation, while preventing the
                      creation of overdosing scenarios.For a treatment plan
                      considering one FLASH and three conventional beams whose
                      dose and dose ratewere sequentially optimized, a homogeneity
                      index of 0.14 and a $D2\%$ equivalent to $109.5\%$ of the
                      totalprescribed dose were achieved. For the simultaneous
                      optimization treatment plans, preconditioningproblems
                      impacted the solution found by the optimizer, and
                      homogeneity indexes of 0.73 and 0.90 werecomputed for plans
                      considering two FLASH and one conventional beams.
                      Nevertheless, the differenttests performed with this
                      optimization strategy illustrate its potential and motivate
                      further research.},
      cin          = {E041},
      cid          = {I:(DE-He78)E041-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)19},
      url          = {https://inrepo02.dkfz.de/record/177455},
}