Why randomized trials for proton therapy are difficult to complete (and what we can do about it)

(University of Pennsylvania School of Medicine) Commercial insurance medical policies that do not cover treatment with proton therapy can make it difficult for patients to participate in randomized clinical trials funded by the NCI, part of the National Institutes of Health, that are evaluating the therapy.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news

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We present modern guidelines to identify adult lymphoma patients who may derive the greatest benefit from proton therapy, along with an analysis of the advantages and disadvantages of proton treatment.
Source: Blood - Category: Hematology Authors: Tags: Special Reports, Free Research Articles, Lymphoid Neoplasia, Clinical Trials and Observations Source Type: research
Authors: Podder TK, Fredman ET, Ellis RJ Abstract Major categories of radiotherapy (RT) for prostate cancer (CaP) treatment are: (1) external beam RT (EBRT), and (2) brachytherapy (BT). EBRT are performed using different techniques like three-dimensional conformal RT (3D-CRT), intensity modulated RT (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body radiation therapy (SBRT), stereotactic radiosurgery (SRS) and intensity modulated proton therapy (IMPT), etc., using a variety of radiation delivery machines, such as a linear accelerator (Linac), Cyberknife robotic system, Gamma knife, Tomotherapy a...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
CONCLUSIONS: Small-spot IMPT improves cord, heart, and lung sparing compared to VMAT and achieves clinically acceptable plan robustness at least for the patients included in this study with motion amplitude less than 11 mm. Our study supports the usage of IMPT to treat some lung cancer patients. PMID: 30328674 [PubMed - as supplied by publisher]
Source: Journal of Applied Clinical Medical Physics - Category: Physics Authors: Tags: J Appl Clin Med Phys Source Type: research
The current standard treatment for oesophageal cancer patients is concomitant chemotherapy and radiotherapy (RT) [1], if possible followed by surgery [2], irradiating large parts of lungs and heart causing toxicity [3,4]. Dose to these organs at risk (OARs) can be reduced using proton therapy (PT) [5 –8]. The hypothesis that dose reduction translates to reduced complication rates is supported by several small non-randomized studies showing lower cardiac and pulmonary complication rates for PT [9–13].
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original article Source Type: research
Two prospective phase II trials were designed to assess the efficacy and safety of image-guided proton therapy (IGPT) for either medically inoperable or operable stage I non-small cell lung cancer (NSCLC). The...
Source: Radiation Oncology - Category: Cancer & Oncology Authors: Tags: Research Source Type: research
We present the results of Monte Carlo simulations in which a water phantom was irradiated with a proton beam. Our results show that the BP position estimated from the 6.13 MeV PG rays can be improved using the proposed position estimation method. Moreover, the 6.92 and 7.12 MeV PG rays can be used for predicting the BP position. However, the accuracy of the BP position estimation decreases with decreasing tissue oxygen levels. We also found that the subtraction of the PG images of 6.13 MeV from those of 6.92 and 7.12 MeV can be used to predict the BP position with a mean accuracy of
Source: Applied Radiation and Isotopes - Category: Radiology Authors: Tags: Appl Radiat Isot Source Type: research
Interest in proton therapy has grown significantly in the past decade due to its dosimetric advantages [1,2]. However, proton therapy is less forgiving to the uncertainties in tumor localization, anatomy changes and setup variations during fractionated treatments than conventional photon radiotherapy, warranting a critical role of daily image guidance. A recent study reported that daily imaging and frequent treatment adaptation should be mandatory for a much higher fraction of lung patients in proton therapy than in IMRT [3].
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original article Source Type: research
Abstract PURPOSE: To evaluate the feasibility of image-guided adaptive proton therapy (IGAPT) with a mobile helical-CT without rails. METHOD: CT images were acquired with a 32-slice mobile CT (mCT) scanning through a 6 degree-of-freedom robotic couch rotated isocentrically 90 degrees from an initial setup position. The relationship between the treatment isocenter and the mCT imaging isocenter was established by a stereotactic reference frame attached to the treatment couch. Imaging quality, geometric integrity and localization accuracy were evaluated according to AAPM TG-66. Accuracy of relative stopping powe...
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
(University of Maryland Medical Center) The Maryland Proton Treatment Center (MPTC) is now offering deep-tissue external thermal therapy in combination with high-precision proton-beam radiotherapy as a potential way to boost survival chances for certain cancer patients. MPTC is the only center in the world to offer these two treatments at the same facility, an advantage to patients because these therapies are typically given within an hour of each other.
Source: EurekAlert! - Cancer - Category: Cancer & Oncology Source Type: news
The most common solid tumours that develop in children originate in the central nervous system (CNS) [1]. Paediatric CNS cancers differ from adult CNS tumours in origin, classification, histology distribution, incidence, and anatomical location [2]. Below the age of fifteen, CNS tumours represent 20% of all cancers, and are commonly located below the tentorium in the posterior fossa. In comparison to adults, an increased incidence of medulloblastoma tumours and reduced incidence of meningioma tumours are present in children [2].
Source: Cancer Treatment Reviews - Category: Cancer & Oncology Authors: Tags: Anti-Tumour Treatment Source Type: research
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