Phantom assessment of lung dose from proton arc therapy

The physics of proton therapy

“…Some of these are enumerated here, with an emphasis on those questions that will require physics research and development to reduce cost, improve treatment quality and efficiency, and create previously new treatment capabilities of clinical importance. Can novel techniques, such as proton arc therapy (Sandison et al , 1997; Sengbusch et al , 2009; Rechner et al , 2012), be developed to improve the quality of treatment, reduce treatment time, and increase cost-competitiveness and -effectiveness?Can cost-competitiveness or treatment capability be increased significantly through incremental improvements to existing accelerator technologies, e.g. , fixed-field alternating gradient synchrotron (Johnstone et al , 1999) and superconducting cyclotron accelerators (Blosser et al , 1997), or novel linear accelerators, e.g.…”

“…Can novel techniques, such as proton arc therapy (Sandison et al , 1997; Sengbusch et al , 2009; Rechner et al , 2012), be developed to improve the quality of treatment, reduce treatment time, and increase cost-competitiveness and -effectiveness?…”

Number of patients potentially eligible for proton therapy

“…Suit et al [59] 1988 Cervical cancer 1 X X Better dose distributions with improved local control, less toxicity Brown et al [60] 1989 Nasopharynx 2 X X Better dose distributions with improved local control, less toxicity Urie'/Gotein [61] 1989 Chordoma/ chondrosarcoma 12 X X X Variably (intensity) modulated protons reduce dose to normal tissues (integral dose by 3 Á/12%-units) compared to fixed (SOBP) protons, however, the largest difference was between protons and photons (2 patients) Austin-Seymour et al [62] 1990 Levin [66] 1992 Para-aortic nodes, cervical cancer 1 X X Higher doses could be reached using protons, improved tumour control by 10 Á/20% Miralbell et al [67] 1992 Maxillary sinus 1 X X Less dose to OARs using a proton boost Slater et al [68] 1992 Tonsil 2 X X Superior dose distributions, higher tumour doses, less doses to OARs (chiefly mandible parotic glands) Smit [69] 1992 Cervical cancer 1 X X Higher doses (by 20%) could be reached using protons, 40% increase in tumour control Tatsuzaki et al [70] 1992 Glioblastoma 1 X X Less dose to non-target brain using protons Wambersie et al [71] 1992 Pediatric brain tumours 3 X X Less dose to non-target brain using protons Miralbell & Urie [72] 1993 Large AVM 1 X X Less dose to non-target brain, brain stem and optic chiasm using protons Lee et al [73] 1994 Prostate 12 X X Distinctly reduced rectal NTCP using protons in one-third of the cases, minimal gain in the remaining Isacsson et al [74] 1996 Rectum 6 X X At 5% NTCP in any organ, TCP is increased by 14%-units with protons Isacsson et al [75] 1997 Ewing/paraspinal 1 X X At 1% NTCP in spinal cord, TCP in increased by 5%-units Miralbell et al [76] 1997 Medulloblastomasupratentorial target 1 X X X Better sparing of normal tissues with protons and IMXT compared to conventional with less IQ-reduction Miralbell et al [77] 1997 Medulloblastoma-spina techa target 1 X X X Decreased dose to all OARs using protons Sandison et al [78] 1997 Chest wall 1 X X Less lung dose using protons Isacsson et al [79] 1998 Oesophagus 5 X X At 5% NTCP in any organ TCP is increased by 20%-units (from 2 to 25%) with protons Verhey et al [80] 1998 CNS 5 X X Less dose to normal brain Fuss et al [81] 1999 Optic nerve, gliomas 7 X X CI 2.9 photons, 2.3 protons, larger differences in larger tumours Glimelius et al [47] 1999 Sacral chordoma 1 X X Lower doses to rectum and urinary bladder using one proton beam compared to 3D-CRT photons Lee et al [82] 1999 Lung 13 X X Mor...…”

Radiation Biology Irradiator Dose Verification Survey

“…Simple physical phantoms, often just slabs of tissue equivalent material, are still critical for standardization procedures; however, anthropomorphic phantoms, which mimic the human body in shape and heterogeneous density distribution, receive significant usage especially in analysis of dose delivery to specific organs (16)(17)(18)(19)(20). The widespread usage of small animal models has spurred development of physical phantoms of mice as well.…”