Ro-17 * initial experience with spot scanning proton therapy for pediatric cns tumors at proton therapy center in trento-italy
(Source: Neuro-Oncology)
Source: Neuro-Oncology - June 12, 2016 Category: Cancer & Oncology Authors: Rombi, B., Vennarini, S., Meneghello, L., Bonazza, C., Pedrotti, D., Dipalma, A., Menegotti, L., Amichetti, M. Tags: RADIATION ONCOLOGY Source Type: research

Optimization and evaluation of multiple gating beam delivery in a synchrotron-based proton beam scanning system using a real-time imaging technique
Increasing numbers of proton therapy centers have adopted the spot-scanning technique. Spot scanning can potentially increase conformity to the target volume and modulates the dose more flexibly than the passive scattering approach. However, in beam scanning, the dose distribution may deteriorate under organ motions, such as respiratory or cardiac motions, during beam delivery [1–4]. Real-time four-dimensional radiotherapy, which includes beam gating [5–7] and beam tracking [8,9], has been realized in photon therapy to mitigate the dosimetric impacts of target motion. (Source: Physica Medica: European Journal of Medical Physics)
Source: Physica Medica: European Journal of Medical Physics - June 10, 2016 Category: Journals (General) Authors: Takahiro Yamada, Naoki Miyamoto, Taeko Matsuura, Seishin Takao, Yusuke Fujii, Yuka Matsuzaki, Hidenori Koyano, Masumi Umezawa, Hideaki Nihongi, Shinichi Shimizu, Hiroki Shirato, Kikuo Umegaki Tags: Technical note Source Type: research

Optimization and evaluation of multiple gating beam delivery in a synchrotron-based proton beam scanning system using a real-time imaging technique.
CONCLUSIONS: The results suggest that the multiple gated-irradiation function has potential to improve the gated irradiation efficiency and to reduce the treatment time. PMID: 27296793 [PubMed - as supplied by publisher] (Source: Medical Physics)
Source: Medical Physics - June 10, 2016 Category: Physics Authors: Yamada T, Miyamoto N, Matsuura T, Takao S, Fujii Y, Matsuzaki Y, Koyano H, Umezawa M, Nihongi H, Shimizu S, Shirato H, Umegaki K Tags: Phys Med Source Type: research

Optimization and evaluation of multiple gating beam delivery in a synchrotron-based proton beam scanning system using a real-time imaging technique
Increasing numbers of proton therapy centers have adopted the spot-scanning technique. Spot scanning can potentially increase conformity to the target volume and modulates the dose more flexibly than the passive scattering approach. However, in beam scanning, the dose distribution may deteriorate under organ motions, such as respiratory or cardiac motions, during beam delivery [1 –4]. Real-time four-dimensional radiotherapy, which includes beam gating [5–7] and beam tracking [8,9], has been realized in photon therapy to mitigate the dosimetric impacts of target motion. (Source: Physica Medica: European Journal of Medical Physics)
Source: Physica Medica: European Journal of Medical Physics - June 10, 2016 Category: Journals (General) Authors: Takahiro Yamada, Naoki Miyamoto, Taeko Matsuura, Seishin Takao, Yusuke Fujii, Yuka Matsuzaki, Hidenori Koyano, Masumi Umezawa, Hideaki Nihongi, Shinichi Shimizu, Hiroki Shirato, Kikuo Umegaki Tags: Technical note Source Type: research

A proton therapy system in Nagoya Proton Therapy Center
Abstract The purpose of this paper is to describe an outline of a proton therapy system in Nagoya Proton Therapy Center (NPTC). The NPTC has a synchrotron with a linac injector and three treatment rooms: two rooms are equipped with a gantry and the other one is equipped with a fixed horizontal beamline. One gantry treatment room has a pencil beam scanning treatment delivery nozzle. The other two treatment rooms have a passive scattering treatment delivery nozzle. In the scanning treatment delivery nozzle, an energy absorber and an aperture system to treat head and neck cancer have been equipped. In the passive tre...
Source: Australasian Physical and Engineering Sciences in Medicine - June 6, 2016 Category: Biomedical Engineering Source Type: research

Different dose rate-dependent responses of human melanoma cells and fibroblasts to low dose fast neutrons.
CONCLUSIONS: Melanoma cells or fibroblasts exert their own survival behaviour at very low doses of neutrons, suggesting that in some cases there is a differential between cancer and normal cells radiation responses. Only the survival of fibroblasts at HDR fits the linear no-threshold model. This new insight into human cell responses to very low doses of neutrons, concerns natural radiations, surroundings of accelerators, proton-therapy devices, flights at high altitude. Furthermore, ATP inhibitors could increase HRS during high-linear energy transfer (high-LET) irradiation. PMID: 27258624 [PubMed - as supplied by publi...
Source: International Journal of Radiation Biology - June 5, 2016 Category: Radiology Tags: Int J Radiat Biol Source Type: research

Tumour control and Quality of Life in children with rhabdomyosarcoma treated with pencil beam scanning proton therapy
To assess clinical outcomes in children with rhabdomyosarcoma (RMS) treated with pencil beam scanning (PBS) proton therapy (PT). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 28, 2016 Category: Radiology Authors: Dominic Leiser, Gabriele Calaminus, Robert Malyapa, Beat Bojaxhiu, Francesca Albertini, Ulrike Kliebsch, Lorentzos Mikroutsikos, Petra Morach, Alessandra Bolsi, Marc Walser, Beate Timmermann, Tony Lomax, Ralf Schneider, Damien C. Weber Tags: Original article Source Type: research

Long term outcomes of patients with skull-base low-grade chondrosarcoma and chordoma patients treated with pencil beam scanning proton therapy
To evaluate the long term tumor control and toxicity of skull base tumors treated with pencil beam scanning proton therapy (PT). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 28, 2016 Category: Radiology Authors: Damien C. Weber, Robert Malyapa, Francesca Albertini, Alessandra Bolsi, Ulrike Kliebsch, Marc Walser, Alessia Pica, Christophe Combescure, Antony J. Lomax, Ralf Schneider Tags: Original article Source Type: research

Long term outcomes of patients with skull-base low-grade chondrosarcoma and chordoma patients treated with pencil beam scanning proton therapy.
CONCLUSIONS: PBS PT is an effective treatment for skull base tumors with acceptable late toxicity. Optic apparatus and/or brainstem compression, histology and GTV allow independent prediction of the risk of local failure and death in skull base tumor patients. PMID: 27247057 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - May 28, 2016 Category: Radiology Authors: Weber DC, Malyapa R, Albertini F, Bolsi A, Kliebsch U, Walser M, Pica A, Combescure C, Lomax AJ, Schneider R Tags: Radiother Oncol Source Type: research

Tumour control and Quality of Life in children with rhabdomyosarcoma treated with pencil beam scanning proton therapy.
CONCLUSIONS: PBS PT led to excellent outcome in children with RMS. Late non-ocular toxicity was minimal and QoL good. PMID: 27247053 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - May 28, 2016 Category: Radiology Authors: Leiser D, Calaminus G, Malyapa R, Bojaxhiu B, Albertini F, Kliebsch U, Mikroutsikos L, Morach P, Bolsi A, Walser M, Timmermann B, Lomax T, Schneider R, Weber DC Tags: Radiother Oncol Source Type: research

Tumour control and Quality of Life in children with rhabdomyosarcoma treated with pencil beam scanning proton therapy
To assess clinical outcomes in children with rhabdomyosarcoma (RMS) treated with pencil beam scanning (PBS) proton therapy (PT). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 28, 2016 Category: Radiology Authors: Dominic Leiser, Gabriele Calaminus, Robert Malyapa, Beat Bojaxhiu, Francesca Albertini, Ulrike Kliebsch, Lorentzos Mikroutsikos, Petra Morach, Alessandra Bolsi, Marc Walser, Beate Timmermann, Tony Lomax, Ralf Schneider, Damien C. Weber Tags: Original article Source Type: research

Long term outcomes of patients with skull-base low-grade chondrosarcoma and chordoma patients treated with pencil beam scanning proton therapy
To evaluate the long term tumor control and toxicity of skull base tumors treated with pencil beam scanning proton therapy (PT). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 28, 2016 Category: Radiology Authors: Damien C. Weber, Robert Malyapa, Francesca Albertini, Alessandra Bolsi, Ulrike Kliebsch, Marc Walser, Alessia Pica, Christophe Combescure, Antony J. Lomax, Ralf Schneider Tags: Original article Source Type: research

Fast and accurate sensitivity analysis of IMPT treatment plans using Polynomial Chaos Expansion.
We present the outcome of our verification experiments based on 6 head-and-neck (HN) patients, and exemplify the usefulness of PCE by comparing a robust and a non-robust treatment plan for a selected HN case. The results suggest that PCE is highly valuable for both research and clinical applications. PMID: 27227661 [PubMed - as supplied by publisher] (Source: Physica Medica)
Source: Physica Medica - May 26, 2016 Category: Physics Authors: Perkó Z, van der Voort SR, van de Water S, Hartman CM, Hoogeman M, Lathouwers D Tags: Phys Med Biol Source Type: research

Does Race Influence Health-related Quality of Life and Toxicity Following Proton Therapy for Prostate Cancer?
Conclusions: After 2 years, there were no disparities in health-related QOL, physician-reported Common Terminology Criteria for Adverse Events GI toxicity, or biochemical relapse. Longer follow-up is needed to confirm these findings. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 25, 2016 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Re‐irradiation using proton beam therapy combined with weekly intra‐arterial chemotherapy for recurrent oral cancer
ConclusionRe‐irradiation using proton beam therapy combined with weekly intra‐arterial chemotherapy improved OS and local control rates compared with other treatment modalities and could become a new treatment modality for patients with recurrent oral cancer. (Source: Asia-Pacific Journal of Clinical Oncology)
Source: Asia-Pacific Journal of Clinical Oncology - May 25, 2016 Category: Cancer & Oncology Authors: Yuichiro HAYASHI, Tatsuya NAKAMURA, Kenji MITSUDO, Kanako KIMURA, Hisashi YAMAGUCHI, Takashi ONO, Yusuke AZAMI, Kanako TAKAYAMA, Katsumi HIROSE, Tomonori YABUUCHI, Motohisa SUZUKI, Yoshiomi HATAYAMA, Yasuhiro KIKUCHI, Hitoshi WADA, Nobukazu FUWA, Masato H Tags: Original article Source Type: research

Investigation into the effects of high-Z nano materials in proton therapy.
This study evaluates the effects of high-Z nano materials in combination with protons, and the impact of proton energy, nanoparticle material and concentration. These effects were studied in silico through Monte Carlo simulation and experimentally through a phantom study, with particular attention to macroscale changes to the Bragg peak in the presence of nanoparticles. Three nanoparticle materials were simulated (gold, silver and platinum) at three concentrations (0.01, 0.1 and 6.5 mg ml(-1)) at two clinical proton energies (60 and 226 MeV). Simulations were verified experimentally using Gafchromic film measurement...
Source: Physica Medica - May 25, 2016 Category: Physics Authors: Ahmad R, Royle G, Lourenço A, Schwarz M, Fracchiolla F, Ricketts K Tags: Phys Med Biol Source Type: research

Re ‐irradiation using proton beam therapy combined with weekly intra‐arterial chemotherapy for recurrent oral cancer
ConclusionRe‐irradiation using proton beam therapy combined with weekly intra‐arterial chemotherapy improved OS and local control rates compared with other treatment modalities and could become a new treatment modality for patients with recurrent oral cancer. (Source: Asia-Pacific Journal of Clinical Oncology)
Source: Asia-Pacific Journal of Clinical Oncology - May 25, 2016 Category: Cancer & Oncology Authors: Yuichiro HAYASHI, Tatsuya NAKAMURA, Kenji MITSUDO, Kanako KIMURA, Hisashi YAMAGUCHI, Takashi ONO, Yusuke AZAMI, Kanako TAKAYAMA, Katsumi HIROSE, Tomonori YABUUCHI, Motohisa SUZUKI, Yoshiomi HATAYAMA, Yasuhiro KIKUCHI, Hitoshi WADA, Nobukazu FUWA, Masato H Tags: Original article Source Type: research

Optimizing multi-stage CdZnTe Compton camera for real-time proton range determination in proton radiotherapy
Conclusions The performance of a CZT Compton camera detector has been studied. A CC efficiency of 0.255% ± 0.034% can be achieved by assembling a triple stage parallel plane CZT detector with stage separations 蠅 3.0cm and detector thicknesses ~1.0cm. Restricting detection to PG’s scattered by 10.1-23.3 will minimize camera angular uncertainty and will consequently improve proton range determination. CC's with efficiency of this magnitude are an improvement over previously investigated triple stage CC's with HPGe detectors and constitutes a promising system for proton range determination in proton radiotherap...
Source: Journal of Nuclear Medicine - May 24, 2016 Category: Nuclear Medicine Authors: Stothers, L., Hou, X., Tanguay, J., Celler, A. Tags: MTA II: Instrumentation Posters Source Type: research

Proton therapy for paediatric CNS tumours — improving treatment-related outcomes
Nature Reviews Neurology 12, 334 (2016). doi:10.1038/nrneurol.2016.70 Authors: Vinai Gondi, Torunn I. Yock & Minesh P. Mehta Radiotherapy is an integral and highly effective aspect of the management of many paediatric CNS tumours, including embryonal tumours, astrocytic tumours and ependymal tumours. Nevertheless, continued improvements in long-term survivorship of such tumours means that radiotherapy-related toxicities that affect quality of life and overall functional (Source: Nature Reviews Neurology)
Source: Nature Reviews Neurology - May 20, 2016 Category: Neurology Authors: Vinai GondiTorunn I. YockMinesh P. Mehta Tags: Review Source Type: research

A simulation study investigating a Cherenkov material for use with the prompt gamma range verification in proton therapy.
Authors: Lau A, Ahmad S, Chen Y Abstract In vivo range verification methods will reveal information about the penetration depth into a patient for an incident proton beam. The prompt gamma (PG) method is a promising in vivo technique that has been shown to yield this range information by measuring the escaping MeV photons given a suitable detector system. The majority of current simulations investigating PG detectors utilize common scintillating materials ideal for photons within a low neutron background radiation field using complex geometries or novel designs. In this work we simulate a minimal detector system us...
Source: Journal of X-Ray Science and Technology - May 17, 2016 Category: Radiology Tags: J Xray Sci Technol Source Type: research

Variable RBE in proton therapy: comparison of different model predictions and their influence on clinical-like scenarios
In proton radiation therapy a constant relative biological effectiveness (RBE) of 1.1 is usually assumed. However, biological experiments have evidenced RBE dependencies on dose level, proton linear energy tra... (Source: Radiation Oncology)
Source: Radiation Oncology - May 17, 2016 Category: Cancer & Oncology Authors: Giulia Giovannini, Till Böhlen, Gonzalo Cabal, Julia Bauer, Thomas Tessonnier, Kathrin Frey, Jürgen Debus, Andrea Mairani and Katia Parodi Source Type: research

Impact of heart and lung dose on early survival in patients with non-small cell lung cancer treated with chemoradiation.
CONCLUSIONS: In a large group of patients treated with chemoradiation for locally advanced NSCLC, heart dose was not found to be associated with early survival outcomes when lung dose was taken into account. Nevertheless, based on the known adverse effects of radiotherapy on vasculature and cardiac function, dose to the heart should be minimized during radiotherapy planning. PMID: 27189523 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - May 14, 2016 Category: Radiology Authors: Tucker SL, Liu A, Gomez D, Tang LL, Allen P, Yang J, Liao Z, Grosshans D Tags: Radiother Oncol Source Type: research

The price of robustness; impact of worst-case optimization on organ-at-risk dose and complication probability in intensity-modulated proton therapy for oropharyngeal cancer patients
To quantify the impact of the degree of robustness against setup errors and range errors on organ-at-risk (OAR) dose and normal tissue complication probabilities (NTCPs) in intensity-modulated proton therapy for oropharyngeal cancer patients. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 10, 2016 Category: Radiology Authors: Steven van de Water, Iris van Dam, Dennis R. Schaart, Abrahim Al-Mamgani, Ben J.M. Heijmen, Mischa S. Hoogeman Tags: Original article Source Type: research

The price of robustness; impact of worst-case optimization on organ-at-risk dose and complication probability in intensity-modulated proton therapy for oropharyngeal cancer patients.
CONCLUSIONS: For oropharyngeal cancer patients, minimizing setup errors should be given a higher priority than minimizing range errors. PMID: 27178142 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - May 10, 2016 Category: Radiology Authors: van de Water S, van Dam I, Schaart DR, Al-Mamgani A, Heijmen BJ, Hoogeman MS Tags: Radiother Oncol Source Type: research

The price of robustness; impact of worst-case optimization on organ-at-risk dose and complication probability in intensity-modulated proton therapy for oropharyngeal cancer patients
To quantify the impact of the degree of robustness against setup errors and range errors on organ-at-risk (OAR) dose and normal tissue complication probabilities (NTCPs) in intensity-modulated proton therapy for oropharyngeal cancer patients. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 10, 2016 Category: Radiology Authors: Steven van de Water, Iris van Dam, Dennis R. Schaart, Abrahim Al-Mamgani, Ben J.M. Heijmen, Mischa S. Hoogeman Tags: Original article Source Type: research

Monitoring 3D dose distributions in proton therapy by reconstruction using an iterative method.
In this study, prompt γ-rays detected by single-photon emission computed tomography with a geometrically optimized collimation system were reconstructed by an iterative method. The falloff position by iterative method (52.48mm) was most similar to the Bragg peak (52mm) of an 80MeV proton compared with those of back-projection (54.11mm) and filtered back-projection (54.91mm) methods. Iterative method also showed better image performance than other methods. PMID: 27179145 [PubMed - as supplied by publisher] (Source: Applied Radiation and Isotopes)
Source: Applied Radiation and Isotopes - May 7, 2016 Category: Radiology Authors: Kim YH, Yoon C, Lee W Tags: Appl Radiat Isot Source Type: research

Why RBE must be a variable and not a constant in proton therapy.
CONCLUSION: Further experimental programmes are proposed, including late normal tissue end points. Better RBE allocations might further improve PT outcomes. Advances in knowledge: This study provides a rigorous critique of the 1.1 RBE used for protons, from theoretical and practical standpoints. Data analysis shows that the LQ model is more appropriate than simple linear regression. Comprehensive research programmes are suggested. PMID: 27146168 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)
Source: The British Journal of Radiology - May 5, 2016 Category: Radiology Authors: Jones B Tags: Br J Radiol Source Type: research

Establishing the feasibility of the dosimetric compliance criteria of RTOG 1308: phase III randomized trial comparing overall survival after photon versus proton radiochemotherapy for inoperable stage II-IIIB NSCLC
To establish the feasibility of the dosimetric compliance criteria of the RTOG 1308 trial through testing against Intensity Modulation Radiation Therapy (IMRT) and Passive Scattering Proton Therapy (PSPT) plans. (Source: Radiation Oncology)
Source: Radiation Oncology - May 4, 2016 Category: Cancer & Oncology Authors: Tawfik Giaddui, Wenzhou Chen, Jialu Yu, Liyong Lin, Charles B. Simone, Lulin Yuan, Yutao U. T. Gong, Q. Jackie Wu, Radhe Mohan, Xiaodong Zhang, Jaques B. Bluett, Michael Gillin, Kevin Moore, Elizabeth O’Meara, Jennifer Presley and Jeffrey D. Bradley Source Type: research

Prospective MRI-based imaging study to assess feasibility of proton therapy for post-prostatectomy radiation.
Abstract PURPOSE/OBJECTIVES: To optimize delivery of post-prostatectomy radiation (PPRT) with protons by examining dosimetric effects of variations in physician contouring, organ motion, and patient alignment during a course of PPRT. MATERIAL AND METHODS: We enrolled 10 patients receiving PPRT in a prospective imaging study. All patients underwent combined computed tomography (CT)/magnetic resonance imaging (MRI) simulation with endorectal balloon (ERB) and received intensity modulated radiation therapy (IMRT) per institutional standards. Study patients underwent weekly MRI verification scans in the treatment...
Source: Acta Oncologica - May 4, 2016 Category: Cancer & Oncology Authors: Swisher-McClure S, Yin L, Rosen M, Batra S, Berman AT, Both S, Vapiwala N Tags: Acta Oncol Source Type: research

Proton Therapy for Pediatric Hodgkin Lymphoma
ConclusionPT for PHL showed no short‐term severe toxicity and yields similar short‐term control to recently published large multi‐institutional clinical trials. (Source: Pediatric Blood and Cancer)
Source: Pediatric Blood and Cancer - May 3, 2016 Category: Cancer & Oncology Authors: Justin Wray, Stella Flampouri, William Slayton, Michael Joyce, Eric Sandler, Christopher G. Morris, Zuofeng Li, Daniel J. Indelicato, Nancy P. Mendenhall, Bradford S. Hoppe Tags: RESEARCH ARTICLE Source Type: research

Dosimetric advantages of intensity-modulated proton therapy for oropharyngeal cancer compared with intensity-modulated radiation: A case-matched control analysis
A potential advantage of intensity-modulated proton therapy (IMPT) over intensity-modulated (photon) radiation therapy (IMRT) in the treatment of oropharyngeal carcinoma (OPC) is lower radiation dose to several critical structures involved in the development of nausea and vomiting, mucositis, and dysphagia. The purpose of this study was to quantify doses to critical structures for patients with OPC treated with IMPT and compare those with doses on IMRT plans generated for the same patients and with a matched cohort of patients actually treated with IMRT. (Source: Medical Dosimetry)
Source: Medical Dosimetry - May 3, 2016 Category: Radiology Authors: Emma B. Holliday, Esengul Kocak-Uzel, Lei Feng, Nikhil G. Thaker, Pierre Blanchard, David I. Rosenthal, G. Brandon Gunn, Adam S. Garden, Steven J. Frank Source Type: research

Feasibility of automated proton therapy plan adaptation for head and neck tumors using cone beam CT images
Intensity modulated proton therapy (IMPT) of head and neck (H&N) tumors may benefit from plan adaptation to correct for the dose perturbations caused by weight loss and tumor volume changes observed in these p... (Source: Radiation Oncology)
Source: Radiation Oncology - April 30, 2016 Category: Cancer & Oncology Authors: Christopher Kurz, Reinoud Nijhuis, Michael Reiner, Ute Ganswindt, Christian Thieke, Claus Belka, Katia Parodi and Guillaume Landry Source Type: research

[Comment] Beyond a moonshot: insurance coverage for proton therapy
Health care in the USA is undergoing fundamental transformation. Implementation of the Patient Protection and Affordable Care Act and ensuing Federal legislative efforts are changing the way cutting-edge scientific innovations are translated to outcomes in patients. At the same time, oncology therapy is advancing rapidly (eg, precision medicine, targeted therapies, and robotic surgery), as is radiotherapy technology (eg, stereotactic body radiotherapy, novel imaging and treatment delivery systems, and proton therapy). (Source: The Lancet Oncology)
Source: The Lancet Oncology - April 27, 2016 Category: Cancer & Oncology Authors: Anand Shah, Kelsey I Ricci, Jason A Efstathiou Tags: Comment Source Type: research

Review of 3D image data calibration for heterogeneity correction in proton therapy treatment planning
Abstract Correct modelling of the interaction parameters of patient tissues is of vital importance in proton therapy treatment planning because of the large dose gradients associated with the Bragg peak. Different 3D imaging techniques yield different information regarding these interaction parameters. Given the rapidly expanding interest in proton therapy, this review is written to make readers aware of the current challenges in accounting for tissue heterogeneities and the imaging systems that are proposed to tackle these challenges. A summary of the interaction parameters of interest in proton therapy and the c...
Source: Australasian Physical and Engineering Sciences in Medicine - April 26, 2016 Category: Biomedical Engineering Source Type: research

Acute Toxicity and Quality of Life in Patients With Prostate Cancer Treated With Protons or Carbon Ions in a Prospective Randomized Phase II Study-The IPI Trial.
CONCLUSIONS: Hypofractionated irradiation using either carbon ions or protons results in comparable acute toxicities and QoL parameters. We found that hypofractionated particle irradiation is feasible and may be safe. Due to the occurrence of gel in the rectal wall and the consecutive occurrence of 2 rectal fistulas, we stopped using the insertion of spacer gel. Longer follow-up is necessary for evaluation of PFS and OS. (Ion Prostate Irradiation (IPI); NCT01641185; ClinicalTrials.gov.). PMID: 27084659 [PubMed - in process] (Source: Physics in Medicine and Biology)
Source: Physics in Medicine and Biology - April 19, 2016 Category: Physics Authors: Habl G, Uhl M, Katayama S, Kessel KA, Hatiboglu G, Hadaschik B, Edler L, Tichy D, Ellerbrock M, Haberer T, Wolf MB, Schlemmer HP, Debus J, Herfarth K Tags: Int J Radiat Oncol Biol Phys Source Type: research

A national approach for automated collection of standardized and population-based radiation therapy data in Sweden.
CONCLUSIONS: An infrastructure for structured and automated prospective collection of syntactically interoperable RT data into a national clinical quality registry for RT data is under implementation. Future developments include adapting MIQA to other treatment modalities (e.g. proton therapy and brachytherapy) and finding strategies to harmonize structure delineations. How the RT registry should comply with domain-specific ontologies such as the Radiation Oncology Ontology (ROO) is under discussion. PMID: 27102842 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society...
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - April 18, 2016 Category: Radiology Authors: Nyholm T, Olsson C, Agrup M, Björk P, Björk-Eriksson T, Gagliardi G, Grinaker H, Gunnlaugsson A, Gustafsson A, Gustafsson M, Johansson B, Johnsson S, Karlsson M, Kristensen I, Nilsson P, Nyström L, Onjukka E, Reizenstein J, Skönevik J, Söderström K, Tags: Radiother Oncol Source Type: research

Commissioning and initial experience with the first clinical gantry-mounted proton therapy system.
We present our commissioning process and initial clinical experience, including i) CT calibration; ii) beam data acquisition and machine characteristics; iii) dosimetric commissioning of the treatment planning system; iv) validation through the Imaging and Radiation Oncology Core credentialing process, includ-ing irradiations on the spine, prostate, brain, and lung phantoms; v) evaluation of localization accuracy of the image guidance system; and vi) initial clinical experi-ence. Clinically, the system operates well and has provided an excellent platform for the treatment of diseases with protons. PMID: 27074470 [PubM...
Source: Journal of Applied Clinical Medical Physics - April 15, 2016 Category: Physics Authors: Zhao T, Sun B, Grantham K, Rankine L, Cai B, Goddu SM, Santanam L, Knutson N, Zhang T, Reilly M, Bottani B, Bradley J, Mutic S, Klein EE Tags: J Appl Clin Med Phys Source Type: research

Quantitative assessment of anatomical change using a virtual proton depth radiograph for adaptive head and neck proton therapy.
Abstract The aim of this work is to demonstrate the feasibility of using water-equivalent thickness (WET) and virtual proton depth radiographs (PDRs) of intensity corrected cone-beam computed tomography (CBCT) to detect anatomical change and patient setup error to trigger adaptive head and neck proton therapy. The planning CT (pCT) and linear accelerator (linac) equipped CBCTs acquired weekly during treatment of a head and neck patient were used in this study. Deformable image registration (DIR) was used to register each CBCT with the pCT and map Hounsfield units (HUs) from the planning CT (pCT) onto the daily CBC...
Source: Journal of Applied Clinical Medical Physics - April 15, 2016 Category: Physics Authors: Wang P, Yin L, Zhang Y, Kirk M, Song G, Ahn PH, Lin A, Gee J, Dolney D, Solberg TD, Maughan R, McDonough J, Teo BK Tags: J Appl Clin Med Phys Source Type: research

Evaluation of the range shifter model for proton pencil-beam scanning for the Eclipse v.11 treatment planning system.
Abstract Existing proton therapy pencil-beam scanning (PBS) systems have limitations on the minimum range to which a patient can be treated. This limitation arises from practical considerations, such as beam current intensity, layer spacing, and delivery time. The range shifter (RS) - a slab of stopping material inserted between the nozzle and the patient - is used to reduce the residual range of the incident beam so that the treatment ranges can be extended to shallow depths. Accurate modeling of the RS allows one to calculate the beam spot size entering the patient, given the proton energy, for arbitrary positio...
Source: Journal of Applied Clinical Medical Physics - April 15, 2016 Category: Physics Authors: Matysiak W, Yeung D, Slopsema R, Li Z Tags: J Appl Clin Med Phys Source Type: research

Perturbation of water-equivalent thickness as a surrogate for respiratory motion in proton therapy.
Abstract Respiratory motion is traditionally assessed using tumor motion magnitude. In proton therapy, respiratory motion causes density variations along the beam path that result in uncertainties of proton range. This work has investigated the use of water-equivalent thickness (WET) to quantitatively assess the effects of respiratory motion on calculated dose in passively scattered proton therapy (PSPT). A cohort of 29 locally advanced non-small cell lung cancer patients treated with 87 PSPT treatment fields were selected for analysis. The variation in WET (ΔWET) along each field was calculated between exha...
Source: Journal of Applied Clinical Medical Physics - April 15, 2016 Category: Physics Authors: Matney JE, Park PC, Li H, Court LE, Zhu XR, Dong L, Liu W, Mohan R Tags: J Appl Clin Med Phys Source Type: research

Miniaturizing Proton Therapy: A Technical Challenge With Unclear Clinical Impact
Recent technical developments in proton therapy on the miniaturization of the irradiation equipment and an increasing interest in smaller proton therapy facilities have cheaper therapy and wider use as their goals. Although smaller facilities, and even ones with a single treatment room, are already in clinical operation, the major technological steps to take this to the next level will need a long time until their introduction into clinical practice. This editorial gives an overview of these developments and an explanation of the current situation regarding technological innovations in clinical practice. (Source: Internati...
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Jacobus Maarten Schippers Tags: Technological Advances Source Type: research

Intensity Modulated Proton Therapy for Head and Neck Tumors: Gilding the Lily or Holy Grail?
To gild refined gold, to paint the lily … is wasteful and ridiculous excess.William Shakespeare, King John, Act IV Sc. 2 (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Steven J. Frank Tags: Politics, Philosophy, and Economics Source Type: research

Proton Therapy for Breast Cancer: Getting to the Heart of the Matter
Proton therapy is an increasingly utilized radiation treatment alternative to photon (x-ray) therapy for malignancies of the breast. Despite a quiescent history of proton use for this disease, breast cancer is now commanding more attention from the proton community than perhaps any other malignancy. The reasons for this are many, some noble and patient-centered and some, perhaps, monetary. Breast cancer is the most common malignancy in American women (1). With a 5-year survival for all-comers estimated at 89%, and an approximate incidence of this disease at 230,000 women per year, we expect an approximate absolute number o...
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Shannon M. MacDonald Tags: Politics, Philosophy, and Economics Source Type: research

Variable Proton Relative Biological Effectiveness: How Do We Move Forward?
In photon radiation therapy, dose prescriptions have been refined over decades of clinical practice to obtain a balance between tumor control and normal tissue damage. Drawing upon this experience, these prescriptions are used as the basis for proton therapy. Historically they have been reduced by a factor of 1.1: a fixed relative biological effectiveness (RBE). Relative biological effectiveness is defined as the ratio of doses required by two radiations to cause the same level of biological effect. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Tracy Underwood, Harald Paganetti Tags: RBE and Particle Therapy Biology Source Type: research

Particles in the South Pacific
No particle therapy facility exists or is being constructed currently in Australia or New Zealand (ANZ). Both jurisdictions have a dual government-funded public health care system as well as a private system, with the majority of radiation therapy provided in the public sector. This is changing rapidly, with an increasing number of private facilities, and the race is now on to open the first proton therapy facility in the South Pacific. Tenders to establish a facility have not been sought by government, which has been the principal source of funding for radiation therapy until now. (Source: International Journal of Radiati...
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Jennifer Chard, Michael Jackson, Giuseppe Sasso, Dion Forstner, Verity Ahern Tags: Politics, Philosophy, and Economics Source Type: research

In the Battle Between Protons and Photons for Hematologic Malignancies, the Patient Must Win
The recent reintroduction of heavy charged particles into therapeutic radiation oncology has rekindled interest in such therapy, particularly with protons, and resulted in an unprecedented increase in the number of proton treatment centers in the United States. Subsequently, despite the higher cost of treatment with protons compared with available nonparticle therapy, the application of proton therapy to every oncologic site has been suggested and debated, to the point where those “for” and “against” protons have held debates in which each side strongly argued their beliefs. (Source: International J...
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Bouthaina S. Dabaja, N. George Mikhaeel Tags: Politics, Philosophy, and Economics Source Type: research

Reconciling Reimbursement for Proton Therapy
“Describe a mechanism to figure out how to pay for proton therapy. Something that will get us out of this mess.”Anthony Zietman, July 20, 2015 (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Peter A.S. Johnstone, John Kerstiens Tags: Politics, Philosophy, and Economics Source Type: research

Compton Camera and Prompt Gamma Ray Timing: Two Methods for In Vivo Range Assessment in Proton Therapy
Fernando Hueso-González, Fine Fiedler, Christian Golnik, Thomas Kormoll, Guntram Pausch, Johannes Petzoldt, Katja E. Römer, Wolfgang Enghardt (Source: Frontiers in Oncology)
Source: Frontiers in Oncology - April 13, 2016 Category: Cancer & Oncology Source Type: research

Reirradiation of Head and Neck Cancers with Proton Therapy: Outcomes and Analyses
We retrospectively reviewed 60 patients treated at our institution with proton beam reirradiation for head and neck cancer. All patients were treated with curative intent, and 73% received concurrent chemotherapy. The 1-year locoregional control, survival and late toxicity rates compare favorably to published 3DCRT and IMRT reports. Retreatment dose was associated with increased acute and late grade 3 toxicities. Proton beam therapy reirradiation should be considered for select patients with head and neck cancer. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Jack Phan, Terence T. Sio, Theresa P. Nguyen, Vinita Takiar, G. Brandon Gunn, Adam S. Garden, David I. Rosenthal, Clifton D. Fuller, William H. Morrison, Beth Beadle, Dominic Ma, Mark A. Zafereo, Kate A. Hutcheson, Michael E. Kupferman, William N. William Tags: Clinical Investigation Source Type: research