Resumen
Proton therapy requires robust optimization to ensure patients receive target coverage and spare normal tissues. However, validation of setup variables has not been studied in patients receiving head and neck proton therapy. The aim of our retrospective study was to evaluate the absolute fractional deviation for dose and volume treatment metrics using 3 mm vs. 5 mm setup robustness in patients treated with head and neck proton therapy. We found that deviations from planning clinical target volumes were greater using 3 mm as compared to 5 mm setup robustness. In addition, variation was greater for patients with primary and secondary clinical targets as compared to primary targets alone. However, the average fractional deviation was less than 1% in primary targets and up to 2% in secondary targets using 3 mm setup uncertainty. We recommend robustness optimization using 3 mm setup uncertainty with daily CBCT for patients being treated with proton head and neck therapy.