Session Item

RTT track: Risk management/quality management
00:00 - 00:00
Practical test of proton plan before first treatment


Practical test of proton plan before first treatment
Authors: HASLUND|, Pernille Opsal(1)*[];Ingerslev|, Ulla(1);Giortz|, Mette(1);Frost|, Simon(1);
(1)Aarhus University Hospital, Danish Center for particle therapy, Aarhus, Denmark;
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Purpose or Objective

The workflow when treating with protons differs from conventional radiotherapy.

The reasons are mainly that the gantry and the couch are two separate units and the risk of collision is present. Furthermore the proton gantry has a snout, which I moving very close to the patient during treatment.

It''s not possible to test the risk of collision when preparing the treatment plan.


A practical test at the gantry is necessary with the following aims:


To maintain patient safety
To minimize the time at the patients first treatment
Quality assurance of the treatment instructions in the clinic
To let the RTT''s practice the specific workflow
To obtain practical experiences to the treatment planners

Material and Methods

A systematic test of the workflow was conducted on 10 treatment plans before the first treatment to identify technical and practical issues.

In the clinic the test was called ''Dry run''.


The following were tested:


Are the planned gantry angles possible?

Planning of the optimal field order?

Test the risk of collision between the gantry and the couch?

Test the risk of collision with the patient?

Planning of the optimal angle to begin the CBCT scan?

Planning of the optimal angles for kV images?

Test if it''s possible to deliver all spots during treatment?


When the treatment plan was tested in the dry run the evaluation was documented in a worksheet.


By conducting the dry runs we decided the optimal field order and directions to move the gantry. Furthermore we identified if the treatment plan wasn''t possible to deliver because of collision.

The RTT''s were technical well prepared at the patient''s first treatment, and expressed it as very positive to be able to focus more on the patient''s needs.

On the basis on the results the instructions for treatment in the clinic was revised.


The dry runs were very important due to patient safety, to minimize time at first treatment and to gain experiences for future treatment plans.

Dry runs are now implemented as a standard in the clinic on all plans before first treatment