Proton Therapy Facility Planning From a Clinical and Operational Model

Das, Indra J.; Moskvin, V.; Zhao, Q.; Cheng, Chee Wai; Johnstone, Peter A.S.

doi:10.7785/tcrt.2012.500444

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…Spot-scanning proton therapy (SSPT), in which a thin proton beam is repeatedly applied to different parts of the target until the whole target area has been covered, makes it possible to irradiate complex targets [ 9 – 11 ]. Due to these characteristics, SSPT might generate a superior dose distribution compared with 3D-CRT and IMRT [ 12 – 15 ]. Thus, the purpose of this study was to perform dosimetric comparisons of 3D-CRT-, IMRT- and SSPT-based WPRT plans for uterine cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Whole-pelvic radiotherapy with spot-scanning proton beams for uterine cervical cancer: a planning study

Hashimoto

Shibamoto

Iwata³

et al. 2016

Journal of Radiation Research

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The aim of this study was to compare the dosimetric parameters of whole-pelvic radiotherapy (WPRT) for cervical cancer among plans involving 3D conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), or spot-scanning proton therapy (SSPT). The dose distributions of 3D-CRT-, IMRT-, and SSPT-based WPRT plans were compared in 10 patients with cervical cancer. All of the patients were treated with a prescribed dose of 50.4 Gy in 1.8-Gy daily fractions, and all of the plans involved the same planning target volume (PTV) constrictions. A 3D-CRT plan involving a four-field box, an IMRT plan involving seven coplanar fields, and an SSPT plan involving four fields were created. The median PTV D95% did not differ between the 3D-CRT, IMRT and SSPT plans. The median conformity index 95% and homogeneity index of the IMRT and SSPT were better than those of the 3D-CRT. The homogeneity index of the SSPT was better than that of the IMRT. SSPT resulted in lower median V20 values for the bladder wall, small intestine, colon, bilateral femoral heads, skin, and pelvic bone than IMRT. Comparing the Dmean values, SSPT spared the small intestine, colon, bilateral femoral heads, skin and pelvic bone to a greater extent than the other modalities. SSPT can reduce the irradiated volume of the organs at risk compared with 3D-CRT and IMRT, while maintaining excellent PTV coverage. Further investigations of SSPT are warranted to assess its role in the treatment of cervical cancer.

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Section: Introductionmentioning

confidence: 99%

Whole-pelvic radiotherapy with spot-scanning proton beams for uterine cervical cancer: a planning study

Hashimoto

Shibamoto

Iwata³

et al. 2016

Journal of Radiation Research

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“…Even for head and neck, proton radiography as well as proton CT have poor image resolution due to multiple coulomb scattering; although the clinical feasibility of this technology is being actively explored [77]. Proton radiography and CT for other disease sites would require higher proton energies [78]. …”

Section: In-room Imaging and Image-guidance For Imptmentioning

confidence: 99%

Empowering Intensity Modulated Proton Therapy Through Physics and Technology: An Overview

Mohan

Das

Ling

2017

International Journal of Radiation Oncology*Biology*Physics

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Considering the clinical potential of protons attributable to their physical characteristics, interest in proton therapy has increased greatly in this century as has the number of proton therapy installations. Until recently, passively scattered proton therapy (PSPT) was used almost entirely. Notably, overall clinical results to date have not shown convincing benefit protons over photons. A rapid transition is now occurring with the implementation of the most advanced form of proton therapy, the intensity-modulated proton therapy (IMPT). IMPT is superior to PSPT and IMRT dosimetrically. However, numerous limitations exist in the present IMPT methods. In particular, compared to IMRT, IMPT is highly vulnerable to various uncertainties. In this overview we identify three major areas of current limitations of IMPT: treatment planning, treatment delivery, and motion management, and discuss current and future efforts for improvement. For treatment planning, we need to reduce uncertainties in proton range and in computed dose distributions, improve robust planning and optimization, enhance adaptive treatment planning and delivery, and consider how to exploit the variability in the relative biological effectiveness (RBE) of protons for clinical benefit. The quality of proton therapy also depends on the characteristics of the IMPT delivery systems and image-guidance. Efforts are needed to optimize the beamlet spot size for both improved dose conformality and faster delivery. For the latter, faster energy switching time and increased dose-rate are also needed. Real-time in-room volumetric imaging for guiding IMPT is in its early stages with CBCT and CT-on-rails, and continued improvements are anticipated. In addition, imaging of the proton beams themselves using, for instance, prompt gamma emissions, is being developed to determine the proton range and to reduce range uncertainty. With the realization of the advances described above, we posit that IMPT, thus empowered, will lead to substantially improved clinical results.

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Reassessment of the Necessity of the Proton Gantry: Analysis of Beam Orientations From 4332 Treatments at the Massachusetts General Hospital Proton Center Over the Past 10 Years

Yan

Flanz

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Proton Therapy Facility Planning From a Clinical and Operational Model

Cited by 4 publications

References 20 publications

Whole-pelvic radiotherapy with spot-scanning proton beams for uterine cervical cancer: a planning study

Whole-pelvic radiotherapy with spot-scanning proton beams for uterine cervical cancer: a planning study

Empowering Intensity Modulated Proton Therapy Through Physics and Technology: An Overview

Reassessment of the Necessity of the Proton Gantry: Analysis of Beam Orientations From 4332 Treatments at the Massachusetts General Hospital Proton Center Over the Past 10 Years

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