Adaptive Radiotherapy for Lung Cancer Using Uniform Scanning Proton Beams

Abstract

Lung cancer remains the leading cause of cancer death in North America and is one of the major indications for proton therapy. Proton beams provide a superior dose distribution due to their finite ranges, but where they stop in the tissue is very sensitive to anatomical change. To ensure optimal target coverage and normal tissue sparing in the presence of geometrical variations, such as tumor shrinkage and other anatomical changes, adaptive planning is necessary in proton therapy of lung cancer. The objective of the chapter is to illustrate the rationale, process, and strategies in adaptive lung cancer treatment using uniform scanning proton beams. In addition, practical considerations for adaptive proton planning are discussed, such as software limitations, the associated costs and risks, and the criteria on whether and how to adapt a plan.

Adaptive planning and toxicities of uniform scanning proton therapy for lung cancer patients

“…Stuschke et al, also reported that IMPT was advantageous in terms of lung sparing compared to both Tomotherapy and IMRT [7]. The dosimetry of USPT for lung cancer was similar to PSPT, as reported by Zheng [14].…”

Sharpening the particle knife: the evolution of ultra-precise proton therapy

“…The advent of US-PT allowed for more precise proton delivery by enabling dose deposition in successive layers using scanning magnets, resulting in a more conformal dose distribution compared with that achievable with PS-PT (8). However, US-PT is still limited to the use of only a single beam energy per layer, without the option of energy modulation during dose delivery of each layer.…”