Whole-pelvis pencil beam scanning (PBS) proton therapy is utilized in both the intact and post-operative settings in patients with prostate cancer. As whole pelvis prostate radiotherapy has traditionally been delivered with standard photon beams, limited evidence and technical descriptions have been reported regarding the use of proton therapy. Here we present two robust three-field treatment planning approaches utilized to maximize target coverage in the presence of anatomic and delivery uncertainties.

Both techniques, conventional optimization (CO) and robust optimization (RO), create treatment plans with acceptable target coverage and sparing of organs at risk (OAR). While the RO method is less time intensive and may theoretically allow for superior OAR sparing and improved robustness, the CO method can be implemented by institutions who do not have RO capabilities.

全骨盆铅笔束扫描 (PBS) 质子治疗可用于前列腺癌患者的完整和术后环境。由于传统上使用标准光子束进行整个盆腔前列腺放射治疗，因此关于使用质子治疗的证据和技术描述有限。在这里，我们提出了两种强大的三场治疗计划方法，用于在存在解剖和交付不确定性的情况下最大化目标覆盖范围。

常规优化 (CO) 和稳健优化 (RO) 这两种技术都可以创建具有可接受的目标覆盖范围和风险器官 (OAR) 保留的治疗计划。虽然 RO 方法时间密集度较低，并且理论上可以允许出色的 OAR 保留和改进的稳健性，但 CO 方法可以由不具备 RO 能力的机构实施。