Risk of second primary cancer from proton arc therapy of pediatric brain tumors

Toussaint, Laura; Indelicato, Daniel J; Muren, Ludvig P; Stokkevåg, Camilla H

doi:10.1016/j.phro.2023.100480

Cited by 1 publication

(1 citation statement)

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“…The authors caution about the potential implications for secondary cancer risk. Conversely, another study examining five pediatric brain tumors evaluated radiation-induced second primary cancer risks [ 93 ]. Using two brain-specific second primary cancer models, the study concluded that the estimated second primary cancer risks were consistently lower for SPArc compared with volumetric modulated arc therapy and IMPT [ 93 ].…”

Section: Current Clinical Practice and Outlook For Future Clinical Pr...mentioning

confidence: 99%

Impact of Relative Biologic Effectiveness for Proton Therapy for Head and Neck and Skull-Base Tumors: A Technical and Clinical Review

Holtzman,

Mohammadi,

Furutani

et al. 2024

Cancers

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Proton therapy has emerged as a crucial tool in the treatment of head and neck and skull-base cancers, offering advantages over photon therapy in terms of decreasing integral dose and reducing acute and late toxicities, such as dysgeusia, feeding tube dependence, xerostomia, secondary malignancies, and neurocognitive dysfunction. Despite its benefits in dose distribution and biological effectiveness, the application of proton therapy is challenged by uncertainties in its relative biological effectiveness (RBE). Overcoming the challenges related to RBE is key to fully realizing proton therapy’s potential, which extends beyond its physical dosimetric properties when compared with photon-based therapies. In this paper, we discuss the clinical significance of RBE within treatment volumes and adjacent serial organs at risk in the management of head and neck and skull-base tumors. We review proton RBE uncertainties and its modeling and explore clinical outcomes. Additionally, we highlight technological advancements and innovations in plan optimization and treatment delivery, including linear energy transfer/RBE optimizations and the development of spot-scanning proton arc therapy. These advancements show promise in harnessing the full capabilities of proton therapy from an academic standpoint, further technological innovations and clinical outcome studies, however, are needed for their integration into routine clinical practice.

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Section: Current Clinical Practice and Outlook For Future Clinical Pr...mentioning

confidence: 99%