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Title: Consensus Guidelines for Implementing Pencil-Beam Scanning Proton Therapy for Thoracic Malignancies on Behalf of the PTCOG Thoracic and Lymphoma Subcommittee

Abstract

Pencil-beam scanning (PBS) proton therapy (PT), particularly intensity modulated PT, represents the latest advanced PT technology for treating cancers, including thoracic malignancies. On the basis of virtual clinical studies, PBS-PT appears to have great potential in its ability to tightly tailor the dose to the target while sparing critical structures, thereby reducing treatment-related toxicities, particularly for tumors in areas with complicated anatomy. However, implementing PBS-PT for moving targets has several additional technical challenges compared with intensity modulated photon radiation therapy or passive scattering PT. Four-dimensional computed tomography–based motion management and robust optimization and evaluation are crucial for minimizing uncertainties associated with beam range and organ motion. Rigorous quality assurance is required to validate dose delivery both before and during the course of treatment. Active motion management (eg, breath hold), beam gating, rescanning, tracking, or adaptive planning may be needed for cases involving significant motion or changes in motion or anatomy over the course of treatment.

Authors:
 [1];  [1];  [2];  [1];  [3];  [4];  [5];  [6];  [7];  [8];  [2];  [9]; ;  [10];  [11];  [7];  [1]
  1. Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  2. Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands)
  3. National Institute of Radiological Sciences for Charged Particle Therapy, Chiba (Japan)
  4. Scripps Proton Center, San Diego, California (United States)
  5. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)
  6. Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona (United States)
  7. Maryland Proton Treatment Center, University of Maryland School of Medicine, Baltimore, Maryland (United States)
  8. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)
  9. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)
  10. University of Florida Proton Therapy Institute, Jacksonville, Florida (United States)
  11. Department of Radiation Oncology, Hokkaido University, Sapporo (Japan)
Publication Date:
OSTI Identifier:
22723007
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 99; Journal Issue: 1; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMPUTERIZED TOMOGRAPHY; LYMPHOMAS; PLATINUM; PROTON BEAMS; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Chang, Joe Y., E-mail: jychang@mdanderson.org, Zhang, Xiaodong, Knopf, Antje, Li, Heng, Mori, Shinichiro, Dong, Lei, Lu, Hsiao-Ming, Liu, Wei, Badiyan, Shahed N., Both, Stephen, Meijers, Arturs, Lin, Liyong, Flampouri, Stella, Li, Zuofeng, Umegaki, Kikuo, Simone, Charles B., and Zhu, Xiaorong R. Consensus Guidelines for Implementing Pencil-Beam Scanning Proton Therapy for Thoracic Malignancies on Behalf of the PTCOG Thoracic and Lymphoma Subcommittee. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2017.05.014.
Chang, Joe Y., E-mail: jychang@mdanderson.org, Zhang, Xiaodong, Knopf, Antje, Li, Heng, Mori, Shinichiro, Dong, Lei, Lu, Hsiao-Ming, Liu, Wei, Badiyan, Shahed N., Both, Stephen, Meijers, Arturs, Lin, Liyong, Flampouri, Stella, Li, Zuofeng, Umegaki, Kikuo, Simone, Charles B., & Zhu, Xiaorong R. Consensus Guidelines for Implementing Pencil-Beam Scanning Proton Therapy for Thoracic Malignancies on Behalf of the PTCOG Thoracic and Lymphoma Subcommittee. United States. doi:10.1016/J.IJROBP.2017.05.014.
Chang, Joe Y., E-mail: jychang@mdanderson.org, Zhang, Xiaodong, Knopf, Antje, Li, Heng, Mori, Shinichiro, Dong, Lei, Lu, Hsiao-Ming, Liu, Wei, Badiyan, Shahed N., Both, Stephen, Meijers, Arturs, Lin, Liyong, Flampouri, Stella, Li, Zuofeng, Umegaki, Kikuo, Simone, Charles B., and Zhu, Xiaorong R. Fri . "Consensus Guidelines for Implementing Pencil-Beam Scanning Proton Therapy for Thoracic Malignancies on Behalf of the PTCOG Thoracic and Lymphoma Subcommittee". United States. doi:10.1016/J.IJROBP.2017.05.014.
@article{osti_22723007,
title = {Consensus Guidelines for Implementing Pencil-Beam Scanning Proton Therapy for Thoracic Malignancies on Behalf of the PTCOG Thoracic and Lymphoma Subcommittee},
author = {Chang, Joe Y., E-mail: jychang@mdanderson.org and Zhang, Xiaodong and Knopf, Antje and Li, Heng and Mori, Shinichiro and Dong, Lei and Lu, Hsiao-Ming and Liu, Wei and Badiyan, Shahed N. and Both, Stephen and Meijers, Arturs and Lin, Liyong and Flampouri, Stella and Li, Zuofeng and Umegaki, Kikuo and Simone, Charles B. and Zhu, Xiaorong R.},
abstractNote = {Pencil-beam scanning (PBS) proton therapy (PT), particularly intensity modulated PT, represents the latest advanced PT technology for treating cancers, including thoracic malignancies. On the basis of virtual clinical studies, PBS-PT appears to have great potential in its ability to tightly tailor the dose to the target while sparing critical structures, thereby reducing treatment-related toxicities, particularly for tumors in areas with complicated anatomy. However, implementing PBS-PT for moving targets has several additional technical challenges compared with intensity modulated photon radiation therapy or passive scattering PT. Four-dimensional computed tomography–based motion management and robust optimization and evaluation are crucial for minimizing uncertainties associated with beam range and organ motion. Rigorous quality assurance is required to validate dose delivery both before and during the course of treatment. Active motion management (eg, breath hold), beam gating, rescanning, tracking, or adaptive planning may be needed for cases involving significant motion or changes in motion or anatomy over the course of treatment.},
doi = {10.1016/J.IJROBP.2017.05.014},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 99,
place = {United States},
year = {2017},
month = {9}
}