A fully flexible joint lattice position and dose optimization method for LATTICE therapy

Lattice radiotherapy (LATTICE) is a form of spatially fractionated radiation therapy (SFRT) designed to deliver high doses to tumor regions while sparing surrounding tissues. Traditional LATTICE uses rigid vertex patterns, limiting adaptability for irregular tumors or those near critical organs. This study introduces a novel planning method with flexible vertex placement and joint optimization of vertex positions and dose distribution, enhancing treatment precision. The method integrates vertex positioning with other treatment variables within a constrained optimization framework, allowing dynamic adjustments. Results showed that plans generated with the new method (NEW) demonstrated superior or comparable quality to conventional LATTICE plans, with improvements in the optimization objective and peak-to-valley dose ratio (PVDR). This approach offers significant improvements in target dose conformity and OAR sparing, providing an enhanced LATTICE technique.