Proton‐to‐photon comparative treatment planning guidelines for the Australian context

Penfold, Scott; Dell’Oro, Mikaela; Gorayski, Peter; Hwang, Eun Ji; Le, Hien; Penfold, Melanie; Sykes, Jonathan; Vu, Hanh; Yeo, Adam

doi:10.1111/1754-9485.13510

Cited by 3 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, completing this process can be associated with clinically significant delays, resulting in the patient being unable to pursue PBT as a treatment option. Of note, the tripartite (RANZCR – Royal Australian and New Zealand College of Radiologists, ACPSEM – Australasian College of Physical Scientists and Engineers in Medicine and ASMIRT) PTSIG has published CPP planning guidelines, 13 which recommends a timeframe of 7 days from patient data acquisition to a CPP plan report.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Developing a comparative photon‐proton planning service in Victoria: the experience at Peter MacCallum Cancer Centre

Gunewardena,

Hall,

et al. 2024

J of Medical Radiation Sci

Self Cite

View full text Add to dashboard Cite

Proton‐beam therapy (PBT) is a cutting‐edge radiation therapy modality that is currently not available in Australia. Comparative photon‐proton (CPP) planning is required for the medical treatment overseas programme (MTOP) and will be required for access to PBT in Australia in the future. Comparative planning brings professional development benefits to all members of the radiation therapy team. This service was also created to support future proposals for a PBT facility in Victoria. We report our experience developing an in‐house CPP service at Peter MacCallum Cancer Centre. A set of resources to support CPP planning was established. Training of relevant staff was undertaken after which an in‐house training programme was developed. A standard protocol for PBT planning parameters was established. All CPP plans were reviewed. Future goals for the CPP planning programme were described. In total, 62 cases were comparatively planned over 54 months. Of these, 60% were paediatric cases, 14% were adolescents and young adults (15–25 years) and 26% were adults. The vast majority (over 75%) of patients comparatively planned required irradiation to the central nervous system including brain and cranio‐spinal irradiation. A variety of proton plans were reviewed by international PBT experts to confirm their deliverability. Our team at Peter MacCallum Cancer Centre has gained significant experience in CPP planning and will continue to develop this further. Local expertise will help support decentralisation of patient selection for proton treatments in the near future and the PBT business case in Victoria.

show abstract

Section: Discussionmentioning

confidence: 99%

“… 1 Energy‐layer dependent in‐air FWHM size at isocentre, typically ranging from 3 to 9 mm for 70 MeV‐250 MeV energy range [Ref 13]. …”

Section: A Summary Of Comparative Photon‐proton Planningmentioning

confidence: 99%

Developing a comparative photon‐proton planning service in Victoria: the experience at Peter MacCallum Cancer Centre

Gunewardena,

Hall,

et al. 2024

J of Medical Radiation Sci

Self Cite

View full text Add to dashboard Cite

show abstract

“…comparative treatment planning will still be required when Australia's first PBT facility opens in Adelaide in 2025. 4 Here we present two patients with brain tumours who had a photon and an in-house proton plan generated to help decide whether a MTOP application for overseas PBT should be submitted.…”

Section: Introductionmentioning

confidence: 99%

“…In Australia, dosimetry is one of the multiple factors including cancer prognosis, the urgency of treatment and patient's family and support network, which help determine the recommended radiation treatment 3 . It is anticipated that proton‐photon comparative treatment planning will still be required when Australia's first PBT facility opens in Adelaide in 2025 4 …”

Section: Introductionmentioning

confidence: 99%

Is proton beam therapy always better than photon irradiation? Lessons from two cases

Li,

Yeo,

Gunewardena

et al. 2024

J of Medical Radiation Sci

Self Cite

View full text Add to dashboard Cite

Proton beam therapy (PBT) is increasingly used to treat cancers, especially in the paediatric and adolescent and young adult (AYA) population. As PBT becomes more accessible, determining when PBT should be used instead of photon irradiation can be difficult. There is a need to balance patient, tumour and treatment factors when making this decision. Comparing the dosimetry between these two modalities plays an important role in this process. PBT can reduce low to intermediate doses to organs at risk (OAR), but photon irradiation has its dosimetric advantages. We present two cases with brain tumours, one paediatric and one AYA, in which treatment plan comparison between photons and protons showed dosimetric advantages of photon irradiation. The first case was an 18‐month‐old child diagnosed with posterior fossa ependymoma requiring adjuvant radiotherapy. Photon irradiation using volumetric modulated arc therapy (VMAT) had lower doses to the hippocampi but higher doses to the pituitary gland. The second case was a 21‐year‐old with an optic pathway glioma. There was better sparing of the critical optic structures and pituitary gland using fractionated stereotactic radiation therapy over PBT. The dosimetric advantages of photon irradiation over PBT have been demonstrated in these cases. This highlights the role of proton‐to‐photon comparative treatment planning to better understand which patients might benefit from photon irradiation versus PBT.

show abstract

Proton beam therapy in paediatric cancer: Anticipating the opening of the Australian Bragg Centre for Proton Therapy and Research

Khong,

Tee,

Gorayski

et al. 2023

J Med Imag Rad Onc

View full text Add to dashboard Cite

SummaryProton Beam Therapy (PBT) has the potential to improve paediatric cancer care by reducing radiation exposure and thus long‐term toxicities. Ethical concerns and debates surrounding the treatment, such as eligibility and accessibility, are ongoing in Australia. The Australian Bragg Centre for Proton Therapy and Research (ABCPTR) (named after Sir William Henry Bragg who described the Bragg peak in his laboratory at the University of Adelaide in 1903) aims to increase access to PBT in Australasia and offer a patient‐centred care approach. Research is underway to assess PBT's safety and cost‐effectiveness, using tools including Normal Tissue Complication Probability (NTCP) models. Collaborative efforts are focused on developing tailored survivorship clinics to enhance patient follow‐up and quality of life. With the anticipated opening of the ABCPTR, Australia is preparing to take a significant step in radiation oncology, offering new research opportunities and creating a publicly funded treatment centre. The initiative aims to balance treatment efficacy with patient care, setting the stage for a future in which radiation therapy will reduce long‐term side effects compared to the current standard of care. The implementation of PBT in Australia represents a complex and promising approach to paediatric oncology. This article provides an overview of the current landscape, highlighting the potential benefits and challenges of a treatment that could redefine the quality of survivorship and contribute to global research and best clinical practice.

show abstract

Proton‐to‐photon comparative treatment planning guidelines for the Australian context

Cited by 3 publications

References 24 publications

Developing a comparative photon‐proton planning service in Victoria: the experience at Peter MacCallum Cancer Centre

Developing a comparative photon‐proton planning service in Victoria: the experience at Peter MacCallum Cancer Centre

Is proton beam therapy always better than photon irradiation? Lessons from two cases

Proton beam therapy in paediatric cancer: Anticipating the opening of the Australian Bragg Centre for Proton Therapy and Research

Contact Info

Product

Resources

About