A case study in proton pencil-beam scanning delivery

International Journal of Radiation Oncology, Biology, Physics
Hanne M KooyJacob B Flanz

Abstract

We completed an implementation of pencil-beam scanning (PBS), a technology whereby a focused beam of protons, of variable intensity and energy, is scanned over a plane perpendicular to the beam axis and in depth. The aim of radiotherapy is to improve the target to healthy tissue dose differential. We illustrate how PBS achieves this aim in a patient with a bulky tumor. Our first deployment of PBS uses "broad" pencil-beams ranging from 20 to 35 mm (full-width-half-maximum) over the range interval from 32 to 7 g/cm(2). Such beam-brushes offer a unique opportunity for treating bulky tumors. We present a case study of a large (4,295 cc clinical target volume) retroperitoneal sarcoma treated to 50.4 Gy relative biological effectiveness (RBE) (presurgery) using a course of photons and protons to the clinical target volume and a course of protons to the gross target volume. We describe our system and present the dosimetry for all courses and provide an interdosimetric comparison. The use of PBS for bulky targets reduces the complexity of treatment planning and delivery compared with collimated proton fields. In addition, PBS obviates, especially for cases as presented here, the significant cost incurred in the construction of field-sp...Continue Reading

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Citations

Oct 10, 2012·Physics in Medicine and Biology·Benjamin M ClasieHanne M Kooy
Feb 15, 2012·Physics in Medicine and Biology·Benjamin ClasieHanne M Kooy
Nov 6, 2014·Medical Physics·M MoteabbedH Paganetti
Oct 23, 2014·Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznań and Polish Society of Radiation Oncology·Sayyed Bijan JiaMahdy Ebrahimi Loushab
Mar 7, 2013·International Journal of Radiation Oncology, Biology, Physics·Clemens GrassbergerHarald Paganetti
Oct 1, 2011·Cancer Science·Hiroki ShiratoKikuo Umegaki
Jan 6, 2015·Journal of Surgical Oncology·Karen De Amorim Bernstein, Thomas F Delaney
Mar 22, 2014·IEEE Transactions on Nuclear Science·Robert P JohnsonDavid Steinberg
Apr 17, 2016·International Journal of Radiation Oncology, Biology, Physics·Maryam MoteabbedHarald Paganetti
May 17, 2015·Medical Physics·Clemens GrassbergerHarald Paganetti
Jan 13, 2015·Practical Radiation Oncology·Hubert Y PanDaniel R Gomez
Jun 19, 2015·The British Journal of Radiology·H M Kooy, C Grassberger
Apr 1, 2015·International Journal of Radiation Oncology, Biology, Physics·Steven van de WaterMischa S Hoogeman
Dec 20, 2013·International Journal of Radiation Oncology, Biology, Physics·Aafke C KraanMischa S Hoogeman
May 15, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Steven van de WaterMischa S Hoogeman
Jul 28, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Mariska A E van de SandeMischa S Hoogeman
Mar 5, 2016·Medical Physics·Frances C CharlwoodRanald I Mackay
Jul 26, 2015·Technology in Cancer Research & Treatment·Stephen DowdellHarald Paganetti
Jun 2, 2017·Medical Physics·Aafke C KraanHanne M Kooy
Nov 26, 2015·Technology in Cancer Research & Treatment·Joost Mathijs VerburgHarald Paganetti
Sep 9, 2017·Reports on Progress in Physics·Robert P Johnson
Jun 7, 2018·Physics in Medicine and Biology·Thyrza JagtMischa Hoogeman
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Jul 24, 2018·Physics in Medicine and Biology·Fernando Hueso-GonzálezJoost M Verburg
Nov 18, 2017·Medical Physics·Aafke Christine KraanHanne M Kooy
Nov 22, 2014·The Cancer Journal·Sameer KeoleThomas B Daniels
Dec 31, 2014·Physics in Medicine and Biology·C GrassbergerH Paganetti
Dec 18, 2015·Physics in Medicine and Biology·Benjamin M ClasieJacob B Flanz
May 27, 2016·Physics in Medicine and Biology·Zoltán PerkóDanny Lathouwers

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