Response to “in regard to “Tran A, Zhang J, Woods K, Yu V, Nguyen D, Gustafson G, Rosen L, Sheng K. Treatment planning comparison of IMPT, VMAT and 4π radiotherapy for prostate cases””

In regard to our recently published paper entitled “Treatment planning comparison of IMPT, VMAT and 4π radiotherapy for prostate cases”, a question was raised whether “4π” was used appropriately to describe the non-coplanar planning and delivery space. In this letter, the term use is explained from both theoretical and practical perspectives. It is concluded that the self-explanatory term provides a flexible description of non-coplanar radiotherapy with beam orientation optimization. Confusions with this term can be avoided by understanding the evolving and machine/patient specific nature of 4π planning,