Towards Achieving the Full Clinical Potential of Proton Therapy by Inclusion of LET and RBE Models

Cancers
B Jones

Abstract

Despite increasing use of proton therapy (PBT), several systematic literature reviews show limited gains in clinical outcomes, with publications mostly devoted to recent technical developments. The lack of randomised control studies has also hampered progress in the acceptance of PBT by many oncologists and policy makers. There remain two important uncertainties associated with PBT, namely: (1) accuracy and reproducibility of Bragg peak position (BPP); and (2) imprecise knowledge of the relative biological effect (RBE) for different tissues and tumours, and at different doses. Incorrect BPP will change dose, linear energy transfer (LET) and RBE, with risks of reduced tumour control and enhanced toxicity. These interrelationships are discussed qualitatively with respect to the ICRU target volume definitions. The internationally accepted proton RBE of 1.1 was based on assays and dose ranges unlikely to reveal the complete range of RBE in the human body. RBE values are not known for human (or animal) brain, spine, kidney, liver, intestine, etc. A simple efficiency model for estimating proton RBE values is described, based on data of Belli et al. and other authors, which allows linear increases in α and β with LET, with a gradient ...Continue Reading

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Citations

May 6, 2016·The British Journal of Radiology·Bleddyn Jones
Aug 23, 2017·Acta Oncologica·Radhe MohanDavid R Grosshans
Aug 19, 2017·Acta Oncologica·B Jones
Aug 14, 2018·Physics in Medicine and Biology·Eivind RørvikKristian S Ytre-Hauge
Apr 26, 2019·Physics in Medicine and Biology·Hong Qi TanJames Cheow Lei Lee
Nov 19, 2019·The British Journal of Radiology·Aimee McNamaraHarald Paganetti
Oct 2, 2020·Acta Oncologica·Iuliana Toma-DasuHåkan Nyström
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Oct 13, 2020·Frontiers in Oncology·Bleddyn Jones
Jun 19, 2021·Cancer Research and Treatment : Official Journal of Korean Cancer Association·Hwa Kyung ByunYong Bae Kim
Sep 16, 2021·International Journal of Radiation Biology·Joshua W MooreBleddyn Jones
Sep 1, 2021·Physics in Medicine and Biology·Erik AlmhagenAnders Ahnesjö

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