Particle Therapy at the “Tipping Point”: An Introduction to the Red Journal's Special Edition

Zietman, Anthony L.

doi:10.1016/j.ijrobp.2016.02.056

Cited by 14 publications

(9 citation statements)

References 20 publications

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“…Proton and particle therapy, which is now becoming routine in several centres, represents another field where several skills are required, underpinned by fundamental physics knowledge. The possibilities given by proton and particle therapy are multiple, summarized by the energy deposition characteristics of protons, which can provide clinically favourable dose distributions in comparison with photons, including considerable reduction of integral dose [60]. The field is complex and still in need of further development not least in imaging, treatment planning, treatment delivery and delivery technology, in all of which technological and physical components are essential [61,62].…”

Section: Fundamental Physicsmentioning

confidence: 99%

Adapting training for medical physicists to match future trends in radiation oncology

Clark

Gagliardi

Heijmen

et al. 2019

Physics and Imaging in Radiation Oncology

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Section: Fundamental Physicsmentioning

confidence: 99%

Adapting training for medical physicists to match future trends in radiation oncology

Clark

Gagliardi

Heijmen

et al. 2019

Physics and Imaging in Radiation Oncology

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“…Many of the others will not survive, and we are thus at a ‘tipping point’. 3 , 7 Payers agreeing to fund patients in trials, or at a reduced standard radiotherapy rate, will help some of the newer centres to survive. Single-gantry facilities and ‘miniaturisation’ will, in time, bring down the start-up costs.…”

Section: A Contracting Industry?mentioning

confidence: 99%

Can proton therapy be considered a standard of care in oncology? Lessons from the United States

Zietman

2019

Br J Cancer

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“…There is growing interest in and enthusiasm for using proton therapy (PT) in cancer management, as evidenced, in part, by the special issue in 2016 on particle therapy in the International Journal of Radiation Oncology, Biology, Physics [1] and the large number of publications on this topic cited in the book entitled Principles and Practice of Proton Beam Therapy [2] and in other books and articles [3]. According to the Particle Therapy Co-Operative Group (PTCOG), the number of proton therapy centers has increased by 40% within the last three years [4].…”

Section: Introductionmentioning

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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Particle Therapy at the “Tipping Point”: An Introduction to the Red Journal's Special Edition

Cited by 14 publications

References 20 publications

Adapting training for medical physicists to match future trends in radiation oncology

Adapting training for medical physicists to match future trends in radiation oncology

Can proton therapy be considered a standard of care in oncology? Lessons from the United States

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

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