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Loyen_31091500_2020.pdf
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- Nowadays, more than 10% of cancers are lung cancers. Radiotherapy is one of the methods used to treat this cancer. It uses radiation to irradiate the cancerous cells to kill them by blocking their ability to proliferate. Proton therapy is a particular radiotherapy technique that enables to deliver the dose locally at the level of the tumor. Proton therapy uses the Pencil Beam Scanning to deliver the dose by scanning point by point the tumor volume. However, the use of this technique leads to the phenomenon of interplay when used with a mobile tumor. If the movements of the PBS and of the tumor are not synchronized, the delivered dose within the target is not uniform and the surrounding tissue is also irradiated. Several methods have been studied to mitigate the effect of interplay. Some of those methods are used in routine while others are still in the research stage. In this context, we evaluate in this master thesis a new approach to reduce the effect of interplay. This new approach consists of a real-time decision making for dose delivery. This means that no treatment plan is fixed in advance and that the optimization of the position where to deliver the dose is done in real-time, taking into account the information received on the patient's anatomy and on the already delivered dose.