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Intensity‐modulated brachytherapy (IMBT) is an emerging technology for cancer treatment, in which radiation sources are shielded to shape the dose distribution. The rotatable shields provide an additional degree of freedom, but also introduce an additional, directional, type of uncertainty, compared to conventional high‐dose‐rate brachytherapy (HDR BT).

We propose and evaluate a robust optimization approach to mitigate the effects of rotational uncertainty in the shields with respect to planning criteria.

A previously suggested prototype for platinum‐shielded prostate ¹⁶⁹Yb‐based dynamic IMBT is considered. We study a retrospective patient data set (anatomical contours and catheter placement) from two clinics, consisting of six patients that had previously undergone conventional ¹⁹²Ir HDR BT treatment. The Monte Carlo‐based treatment planning software …