Secondary neutron doses in a compact proton therapy system

Stichelbaut, F.; Closset, M.; Jongen, Y.

doi:10.1093/rpd/ncu028

Cited by 12 publications

(7 citation statements)

References 2 publications

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“…This reduction in physical size would normally increase concern over the impact of neutron scatter. However, Monte Carlo modeling of the neutron scatter dose contribution to an anthropomorphic phantom, (adult sized) produced neutron doses in organs lying close to the primary field, (oesophagus and heart in this case) ranging from 4.3 to 7.1 millisieverts per treatment Gray and introduced no significant increase in second cancer risk [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison and Potential for Improved Clinical Outcomes of Paediatric CNS Patients Treated with Protons or IMRT

Armoogum

Thorp

2015

Cancers

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Background: We compare clinical outcomes of paediatric patients with CNS tumours treated with protons or IMRT. CNS tumours form the second most common group of cancers in children. Radiotherapy plays a major role in the treatment of many of these patients but also contributes to late side effects in long term survivors. Radiation dose inevitably deposited in healthy tissues outside the clinical target has been linked to detrimental late effects such as neurocognitive, behavioural and vascular effects in addition to endocrine abnormalities and second tumours. Methods: A literature search was performed using keywords: protons, IMRT, CNS and paediatric. Of 189 papers retrieved, 10 were deemed relevant based on title and abstract screening. All papers directly compared outcomes from protons with photons, five papers included medulloblastoma, four papers each included craniopharyngioma and low grade gliomas and three papers included ependymoma. Results: This review found that while proton beam therapy offered similar clinical target coverage, there was a demonstrable reduction in integral dose to normal structures. Conclusions: This in turn suggests the potential for superior long term outcomes for paediatric patients with CNS tumours both in terms of radiogenic second cancers and out-of-field adverse effects.

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Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison and Potential for Improved Clinical Outcomes of Paediatric CNS Patients Treated with Protons or IMRT

Armoogum

Thorp

2015

Cancers

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“…Stochastic effects, generally late effects such as carcinogenesis, are probabilistic in nature. Although the impact of neutrons on stochastic effects is not clear, the stochastic effects of neutrons and mixed-field exposures are being studied, as demonstrated by the available literature on carcinogenic effects of neutrons (37)(38)(39)(40). However, further research is needed to improve understanding of the risk associated with exposures below the level at which deterministic effects occur.…”

Section: Neutron Radiobiologymentioning

confidence: 99%

Neutron Radiobiology and Dosimetry

et al. 2021

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As the U.S. prepares for the possibility of a radiological or nuclear incident, or anticipated lunar and Mars missions, the exposure of individuals to neutron radiation must be considered. More information is needed on how to determine the neutron dose to better estimate the true biological effects of neutrons and mixed-field (i.e., neutron and photon) radiation exposures. While exposure to gamma-ray radiation will cause significant health issues, the addition of neutrons will likely exacerbate the biological effects already anticipated after radiation exposure. To begin to understand the issues and knowledge gaps in these areas, the National Institute of Allergy and Infectious Diseases (NIAID), Radiation Nuclear Countermeasures Program (RNCP), Department of Defense (DoD), Defense Threat Reduction Agency (DTRA), and National Aeronautics and Space Administration (NASA) formed an inter-agency working group to host a Neutron Radiobiology and Dosimetry Workshop on March 7, 2019 in Rockville, MD. Stakeholder interests were clearly positioned, given the differences in the missions of each agency. An overview of neutron dosimetry and neutron radiobiology was included, as well as a historical overview of neutron exposure research. In addition, current research in the fields of biodosimetry and diagnostics, medical countermeasures (MCMs) and treatment, long-term health effects, and computational studies were presented and discussed.

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“…Howell et al (2016) and Chen et al (2013) have reported similar secondary neutron dose levels using this compact system compared with other proton beam-lines for passive scattering. Stichelbaut et al (2014) performed a Monte Carlo simulation study investigating secondary neutron dose levels comparing the Mevion solution for pencil-beam scanning mode with the IBA ProteusONE compact system. They concluded that the secondary cancer risk did not increase for ProteusONE, but did increase by a factor of 3.74 for the gantry-mounted cyclotron with range-shifter-only energy selection, compared with a large multi-room layout facility using pencil-beam scanning.…”

Section: Compact Layout Systemsmentioning

confidence: 99%

“…(2013) have reported similar secondary neutron dose levels using this compact system compared with other proton beam-lines for passive scattering. Stichelbaut et al. (2014) performed a Monte Carlo simulation study investigating secondary neutron dose levels comparing the Mevion solution for pencil-beam scanning mode with the IBA ProteusONE compact system.…”

Section: Compact Layout Systemsmentioning

confidence: 99%

Proton therapy technology evolution in the clinic: impact on radiation protection

Depuydt

2018

Ann ICRP

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The use of proton therapy as a treatment modality is becoming more widespread in conventional radiation therapy practice. Commercialisation and introduction of compact systems has led to embedding of proton therapy facilities in existing hospital environments. In addition, technologically, proton therapy is currently undergoing an important evolution, moving from passive scattering delivery techniques to active pencil beam scanning, adopting image guidance techniques from conventional radiotherapy and introducing various range verification techniques in the clinic. An overview is given of today's technological evolution of proton therapy in clinical environments, and its impact on aspects of radiation protection.

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Secondary neutron doses in a compact proton therapy system

Cited by 12 publications

References 2 publications

Dosimetric Comparison and Potential for Improved Clinical Outcomes of Paediatric CNS Patients Treated with Protons or IMRT

Dosimetric Comparison and Potential for Improved Clinical Outcomes of Paediatric CNS Patients Treated with Protons or IMRT

Neutron Radiobiology and Dosimetry

Proton therapy technology evolution in the clinic: impact on radiation protection

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