Spatially fractionated (<scp>GRID</scp>) radiation therapy using proton pencil beam scanning (<scp>PBS</scp>): Feasibility study and clinical implementation

Gao, M.; Mohiuddin, Majid; Hartsell, William F.; Pankuch, Mark

doi:10.1002/mp.12807

Cited by 39 publications

(26 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is different to GRID irradiation, which is used clinically to debulk large tumours, for which the goal is to deliver high dose peaks, rather than a uniform dose (see, e.g. 11 ). Clinically relevant proof-of-concept results can only be obtained using proton minibeam irradiation in an animal model where the complexity of irradiation effects, including the response of vasculature and immune system, can be analysed.…”

Section: Small Animal Studiesmentioning

confidence: 99%

Spatially fractionated proton minibeams

Meyer

Eley

Schmid

et al. 2019

BJR

View full text Add to dashboard Cite

Technological advances in radiation delivery and treatment planning have notably improved the shaping of high dose regions to the surface of tumour volumes and this conformal precision also reduces dose to organs-at-risk. 1 However, treatments of tumours close to sensitive structures, such as the central nervous system, as well paediatric cancers are still compromised by the upper tolerance dose of normal tissue structures. Finding novel approaches that reduce normal tissue damage is of utmost importance. This is the case for the utilization of distinct spatial dose distributions, commonly referred to as spatially fractionated radiation therapy (SFRT). In SFRT, irradiation is performed by using highly spatially modulated beams, as illustrated in Figure 1. The dose profiles on the beam entrance side consist of peaks and valleys in contrast to homogeneous profiles in standard radiation therapy (RT). The beams may be spatially fractionated in one or two directions, referred to as micro/ minibeams (Figure 1a) and GRID (Figure 1b), respectively. The concept of SFRT was first introduced in 1909 by German physician, Alban Köhler, 2,3 to achieve better skin sparing for deep seated tumours. The value of GRID or Sieve therapy for the treatment of difficult cases without risk of skin necrosis was further reported in the 1950s. 4-7 The advent of megavoltage beams for RT, providing higher penetration and better skin sparing, resulted in SFRT to be consigned to oblivion for several decades. GRID therapy was "rediscovered" in the 1970s using Co-60 units 8,9 and later in the 1990s by using megavoltage beams provided by medical linear accelerators (linacs). 10 Linac-based grid therapy is still in use at a few hospitals in the USA, recently also with clinical proton beams, 11,12 to deliver large, single fraction doses to patients with bulky tumours to shrink or palliate the disease with minimum damage to normal tissues. 13-18 In parallel developments, pre-clinical research was carried out by Curtis, Zeman and co-workers 19-21 at Brookhaven National Laboratory, starting in 1959, in the context of studies on the possible biological effects of cosmic radiation. They observed a highly non-linear inverse relationship between radiosensitivity and tissue volume exposed. The experiment they conducted involved irradiation of mouse brains with a deuteron beam of varying sizes and

show abstract

Section: Small Animal Studiesmentioning

confidence: 99%

Spatially fractionated proton minibeams

Meyer

Eley

Schmid

et al. 2019

BJR

View full text Add to dashboard Cite

show abstract

“…GRID is being utilized with protons as well, since protons have the unique advantage of minimizing or even eliminating exit dose in normal tissues located beyond the tumor due to its inherent property (i.e. the Bragg peak) and potentially less scattering in normal tissues [26]. When proton is used instead of photon in GRID therapy, it successfully replicated the valley-to-peak ratios inside tumor.…”

Section: Sfrt With Particle Therapymentioning

confidence: 99%

“…The depth-dose curve dropped quickly beyond the target and resulted in a more uniform beamlet dose within the tumor. Proton PBS has been tested in patients and can reduce the dose to proximal organs when treating a deep-seated tumor [26]. Carbon-ion beam has been evaluated for GRID treatment, GRIDs containing 0.5 or 3 mm wide carbon ion beam share similar characteristics with GRID therapy.…”

Section: Sfrt With Particle Therapymentioning

confidence: 99%

Spatially fractionated radiation therapy: History, present and the future

Yan

Khan

Wu³

et al. 2020

Clinical and Translational Radiation Oncology

View full text Add to dashboard Cite

“…For this and other reasons, FLASH-RT has caught the field by surprise, where a relatively straightforward change in beam delivery has led to significant improvements in the therapeutic index, heretofore unrealized by other advancements in medical physics. One fascinating observation is that pencil beam proton GRID techniques might blend the advantages of both SFRT and FLASH (since the dose-rates at the distal edge of the beamlets might be in the FLASH dose-rate range) (74). Table 1 is a primer and quick reference/summary of this meeting report and the discussion to date by members of the program and assembled working groups regarding the state of research and translation potential for each sub-area of the broader movement to find innovative uses for ionizing radiation.…”

Section: Overall Summary and Conclusionmentioning

confidence: 99%

Understanding High-Dose, Ultra-High Dose Rate, and Spatially Fractionated Radiation Therapy

Griffin

Ahmed²,

Amendola

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

While the workshop was co-sponsored by the NCI and RSS, the comments in this report are strictly the opinions of the co-authors and does not constitute endorsement of these results and/or treatments by the NCI and RSS or consensus of all the co-authors on each of the points. This report is designed to stimulate further formal research and development to explore the future clinical application of these novel therapies and not for implementation into routine clinical practice.

show abstract

Spatially fractionated (GRID) radiation therapy using proton pencil beam scanning (PBS): Feasibility study and clinical implementation

Cited by 39 publications

References 27 publications

Spatially fractionated proton minibeams

Spatially fractionated proton minibeams

Spatially fractionated radiation therapy: History, present and the future

Understanding High-Dose, Ultra-High Dose Rate, and Spatially Fractionated Radiation Therapy

Contact Info

Product

Resources

About