International Journal of Particle Therapy最新文献

{"title":"Particle Beam Radiobiology Status and Challenges: A PTCOG Radiobiology Subcommittee Report.","authors":"Reem Ahmad, Amelia Barcellini, Kilian Baumann, Malte Benje, Tamara Bender, Paloma Bragado, Alexandra Charalampopoulou, Reema Chowdhury, Anthony J Davis, Daniel K Ebner, John Eley, Jake A Kloeber, Robert W Mutter, Thomas Friedrich, Alvaro Gutierrez-Uzquiza, Alexander Helm, Marta Ibáñez-Moragues, Lorea Iturri, Jeannette Jansen, Miguel Ángel Morcillo, Daniel Puerta, Anggraeini Puspitasari Kokko, Daniel Sánchez-Parcerisa, Emanuele Scifoni, Takashi Shimokawa, Olga Sokol, Michael D Story, Juliette Thariat, Walter Tinganelli, Francesco Tommasino, Charlot Vandevoorde, Cläre von Neubeck","doi":"10.1016/j.ijpt.2024.100626","DOIUrl":"10.1016/j.ijpt.2024.100626","url":null,"abstract":"<p><p>Particle therapy (PT) represents a significant advancement in cancer treatment, precisely targeting tumor cells while sparing surrounding healthy tissues thanks to the unique depth-dose profiles of the charged particles. Furthermore, their linear energy transfer and relative biological effectiveness enhance their capability to treat radioresistant tumors, including hypoxic ones. Over the years, extensive research has paved the way for PT's clinical application, and current efforts aim to refine its efficacy and precision, minimizing the toxicities. In this regard, radiobiology research is evolving toward integrating biotechnology to advance drug discovery and radiation therapy optimization. This shift from basic radiobiology to understanding the molecular mechanisms of PT aims to expand the therapeutic window through innovative dose delivery regimens and combined therapy approaches. This review, written by over 30 contributors from various countries, provides a comprehensive look at key research areas and new developments in PT radiobiology, emphasizing the innovations and techniques transforming the field, ranging from the radiobiology of new irradiation modalities to multimodal radiation therapy and modeling efforts. We highlight both advancements and knowledge gaps, with the aim of improving the understanding and application of PT in oncology.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"13 ","pages":"100626"},"PeriodicalIF":2.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11386331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Translation of a Deep Learning Model of Radiation-Induced Lymphopenia for Esophageal Cancer.","authors":"Zongsheng Hu, Radhe Mohan, Yan Chu, Xiaochun Wang, Peter S N van Rossum, Yiqing Chen, Madison E Grayson, Angela G Gearhardt, Clemens Grassberger, Degui Zhi, Brian P Hobbs, Steven H Lin, Wenhua Cao","doi":"10.1016/j.ijpt.2024.100624","DOIUrl":"10.1016/j.ijpt.2024.100624","url":null,"abstract":"<p><strong>Purpose: </strong>Radiation-induced lymphopenia is a common immune toxicity that adversely impacts treatment outcomes. We report here our approach to translate a deep-learning (DL) model developed to predict severe lymphopenia risk among esophageal cancer into a strategy for incorporating the immune system as an organ-at-risk (iOAR) to mitigate the risk.</p><p><strong>Materials and methods: </strong>We conducted \"virtual clinical trials\" utilizing retrospective data for 10 intensity-modulated radiation therapy (IMRT) and 10 passively-scattered proton therapy (PSPT) esophageal cancer patients. For each patient, additional treatment plans of the modality other than the original were created employing standard-of-care (SOC) dose constraints. Predicted values of absolute lymphocyte count (ALC) nadir for all plans were estimated using a previously-developed DL model. The model also yielded the relative magnitudes of contributions of iOARs dosimetric factors to ALC nadir, which were used to compute iOARs dose-volume constraints, which were incorporated into optimization criteria to produce \"IMRT-enhanced\" and \"intensity-modulated proton therapy (IMPT)-enhanced\" plans.</p><p><strong>Results: </strong>Model-predicted ALC nadir for the original IMRT (IMRT-SOC) and PSPT plans agreed well with actual values. IMPT-SOC showed greater immune sparing vs IMRT and PSPT. The average mean body doses were 13.10 Gy vs 7.62 Gy for IMRT-SOC vs IMPT-SOC for patients treated with IMRT-SOC; and 8.08 Gy vs 6.68 Gy for PSPT vs IMPT-SOC for patients treated with PSPT. For IMRT patients, the average predicted ALC nadir of IMRT-SOC, IMRT-enhanced, IMPT-SOC, and IMPT-enhanced was 281, 327, 351, and 392 cells/µL, respectively. For PSPT patients, the average predicted ALC nadir of PSPT, IMPT-SOC, and IMPT-enhanced was 258, 316, and 350 cells/µL, respectively. Enhanced plans achieved higher predicted ALC nadir, with an average improvement of 40.8 cells/µL (20.6%).</p><p><strong>Conclusion: </strong>The proposed DL model-guided strategy to incorporate the immune system as iOAR in IMRT and IMPT optimization has the potential for radiation-induced lymphopenia mitigation. A prospective clinical trial is planned.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"13 ","pages":"100624"},"PeriodicalIF":2.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cone-Beam CT Images as an Indicator of QACT During Adaptive Proton Therapy of Extremity Sarcomas.","authors":"Nrusingh C Biswal, Baoshe Zhang, Elizabeth Nichols, Matthew E Witek, William F Regine, ByongYong Yi","doi":"10.1016/j.ijpt.2024.100017","DOIUrl":"10.1016/j.ijpt.2024.100017","url":null,"abstract":"<p><strong>Purpose: </strong>Periodic quality assurance CTs (QACTs) are routine in proton beam therapy. In this study, we tested whether the necessity for a QACT could be determined by evaluating the change in beam path length (BPL) on daily cone-beam CT (CBCT).</p><p><strong>Patients and methods: </strong>In this Institutional Review Board-approved study, we retrospectively analyzed 959 CBCT images from 78 patients with sarcomas treated with proton pencil-beam scanning. Plans on 17 QACTs out of a total of 243 were clinically determined to be replanned for various reasons. Daily CBCTs were retrospectively analyzed by automatic ray-tracing of each beam from the isocenter to the skin surface along the central axis. A script was developed for this purpose. Patterns of change in BPL on CBCT images were compared to those from adaptive planning using weekly QACTs.</p><p><strong>Results: </strong>Sixteen of the 17 adaptive replans showed BPL changes ≥4 mm for at least 1 of the beams on 3 consecutive CBCT sessions. Similarly, 43 of 63 nonadaptively planned patients had BPL changes <4 mm for all of the beams. A new QACT criterium of a BPL change of any beam ≥4 mm on 3 consecutive CBCT sessions resulted in a sensitivity of 94.1% and a specificity of 68.3%. Had the BPL change been used as the QACT predictor, a total of 37 QACTs would have been performed rather than 243 QACTs in clinical practice.</p><p><strong>Conclusion: </strong>The use of BPL changes on CBCT images represented a significant reduction (85%) in total QACT burden while maintaining treatment quality and accuracy. QACT can be performed only when it is needed, but not in a periodic manner. The benefits of reducing QACT frequency include reducing imaging dose and optimizing patient time and staff resources.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"12 ","pages":"100017"},"PeriodicalIF":2.1,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11252065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PTCOG Gastrointestinal Subcommittee Lower Gastrointestinal Tract Malignancies Consensus Statement.","authors":"J Isabelle Choi, Andrzej Wojcieszynski, Richard A Amos, Huan Giap, Smith Apisarnthanarax, Jonathan B Ashman, Aman Anand, Luis A Perles, Tyler Williamson, Shanmugasundaram Ramkumar, Jason Molitoris, Charles B Simone, Michael D Chuong","doi":"10.1016/j.ijpt.2024.100019","DOIUrl":"https://doi.org/10.1016/j.ijpt.2024.100019","url":null,"abstract":"<p><strong>Purpose: </strong>Radiotherapy delivery in the definitive management of lower gastrointestinal (LGI) tract malignancies is associated with substantial risk of acute and late gastrointestinal (GI), genitourinary, dermatologic, and hematologic toxicities. Advanced radiation therapy techniques such as proton beam therapy (PBT) offer optimal dosimetric sparing of critical organs at risk, achieving a more favorable therapeutic ratio compared with photon therapy.</p><p><strong>Materials and methods: </strong>The international Particle Therapy Cooperative Group GI Subcommittee conducted a systematic literature review, from which consensus recommendations were developed on the application of PBT for LGI malignancies.</p><p><strong>Results: </strong>Eleven recommendations on clinical indications for which PBT should be considered are presented with supporting literature, and each recommendation was assessed for level of evidence and strength of recommendation. Detailed technical guidelines pertaining to simulation, treatment planning and delivery, and image guidance are also provided.</p><p><strong>Conclusion: </strong>PBT may be of significant value in select patients with LGI malignancies. Additional clinical data are needed to further elucidate the potential benefits of PBT for patients with anal cancer and rectal cancer.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"11 ","pages":"100019"},"PeriodicalIF":1.7,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Status and Challenges for Prostate Stereotactic Body Radiation Therapy Treatments in United States Proton Therapy Centers: An NRG Oncology Practice Survey.","authors":"Jiajian Shen, Paige A Taylor, Carlos E Vargas, Minglei Kang, Jatinder Saini, Jun Zhou, Peilong Wang, Wei Liu, Charles B Simone, Ying Xiao, Liyong Lin","doi":"10.1016/j.ijpt.2024.100020","DOIUrl":"10.1016/j.ijpt.2024.100020","url":null,"abstract":"<p><strong>Purpose: </strong>To report the current practice pattern of the proton stereotactic body radiation therapy (SBRT) for prostate treatments.</p><p><strong>Materials and methods: </strong>A survey was designed to inquire about the practice of proton SBRT treatment for prostate cancer. The survey was distributed to all 30 proton therapy centers in the United States that participate in the National Clinical Trial Network in February, 2023. The survey focused on usage, patient selection criteria, prescriptions, target contours, dose constraints, treatment plan optimization and evaluation methods, patient-specific QA, and image-guided radiation therapy (IGRT) methods.</p><p><strong>Results: </strong>We received responses from 25 centers (83% participation). Only 8 respondent proton centers (32%) reported performing SBRT of the prostate. The remaining 17 centers cited 3 primary reasons for not offering this treatment: no clinical need, lack of volumetric imaging, and/or lack of clinical evidence. Only 1 center cited the reduction in overall reimbursement as a concern for not offering prostate SBRT. Several common practices among the 8 centers offering SBRT for the prostate were noted, such as using Hydrogel spacers, fiducial markers, and magnetic resonance imaging (MRI) for target delineation. Most proton centers (87.5%) utilized pencil beam scanning (PBS) delivery and completed Imaging and Radiation Oncology Core (IROC) phantom credentialing. Treatment planning typically used parallel opposed lateral beams, and consistent parameters for setup and range uncertainties were used for plan optimization and robustness evaluation. Measurements-based patient-specific QA, beam delivery every other day, fiducial contours for IGRT, and total doses of 35 to 40 GyRBE were consistent across all centers. However, there was no consensus on the risk levels for patient selection.</p><p><strong>Conclusion: </strong>Prostate SBRT is used in about 1/3 of proton centers in the US. There was a significant consistency in practices among proton centers treating with proton SBRT. It is possible that the adoption of proton SBRT may become more common if proton SBRT is more commonly offered in clinical trials.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"11 ","pages":"100020"},"PeriodicalIF":2.1,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes Following Definitive or Adjuvant Proton Radiotherapy for Adenoid Cystic Carcinoma.","authors":"Etzer Augustin, Adam L Holtzman, Roi Dagan, Curtis M Bryant, Daniel J Indelicato, Christopher G Morris, Rohan L Deraniyagala, Rui P Fernandes, Anthony M Bunnell, Stacey M Nedrud, William M Mendenhall","doi":"10.1016/j.ijpt.2024.100008","DOIUrl":"https://doi.org/10.1016/j.ijpt.2024.100008","url":null,"abstract":"<p><strong>Purpose: </strong>Adenoid cystic carcinoma (ACC) is a rare malignancy accounting for 1% of all head and neck cancers. Treatment for ACC has its challenges and risks, yet few outcomes studies exist. We present long-term outcomes of patients with ACC of the head and neck treated with proton therapy (PT).</p><p><strong>Materials and methods: </strong>Under an institutional review board-approved, single-institutional prospective outcomes registry, we reviewed the records of 56 patients with de novo, nonmetastatic ACC of the head and neck treated with PT with definitive (<i>n</i> = 9) or adjuvant PT (<i>n</i> = 47) from June 2007 to December 2021. The median dose to the primary site was 72.6 gray relative biological equivalent (range, 64-74.4) delivered as either once (<i>n</i> = 19) or twice (<i>n</i> = 37) daily treatments. Thirty patients received concurrent chemotherapy. Thirty-one patients received nodal radiation, 30 electively and 1 for nodal involvement.</p><p><strong>Results: </strong>With a median follow-up of 6.2 years (range, 0.9-14.7), the 5-year local-regional control (LRC), disease-free survival, cause-specific survival, and overall survival rates were 88%, 85%, 89%, and 89%, respectively. Intracranial extension (<i>P</i> = .003) and gross residual tumor (<i>P</i> = .0388) were factors associated with LRC rates. While the LRC rate for those with a gross total resection was 96%, those with subtotal resection or biopsy alone were 81% and 76%, respectively. The 5-year cumulative incidence of clinically significant grade ≥3 toxicity was 15%, and the crude incidence at the most recent follow-up was 23% (<i>n</i> = 13).</p><p><strong>Conclusion: </strong>This is the largest sample size with the longest median follow-up to date of patients with ACC treated with PT. PT can provide excellent disease control for ACC of the head and neck with acceptable toxicity. T4 disease, intracranial involvement, and gross residual disease at the time of PT following either biopsy or subtotal resection were significant prognostic features for worse outcomes.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"11 ","pages":"100008"},"PeriodicalIF":1.7,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11096740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic Operational Redesign Improves Prior Authorization Access: A Validation Study.","authors":"Eric D Brooks, Fantine Giap, Vincent Cassidy, Matthew S Ning, Bradlee Robbert, Polly Redding, Matthew Palmer, L Montreal Turner, William M Mendenhall, Stuart Klein, Nancy P Mendenhall","doi":"10.14338/IJPT-23-00009.1","DOIUrl":"10.14338/IJPT-23-00009.1","url":null,"abstract":"<p><strong>Purpose: </strong>Obtaining prior authorization (PA) before treatment is becoming increasingly burdensome in oncology, especially in radiation oncology. Here, we describe the impact of a strategic novel operational PA redesign to shorten authorization time and to improve patient access to cancer care at a large United States academic proton therapy center. We ask whether such a redesign may be replicable and adoptable across oncology centers.</p><p><strong>Materials and methods: </strong>Our PA redesign strategy was based on a 3-tiered approach. Specifically, we (1) held payors accountable to legally backed timelines, (2) leveraged expertise on insurance policies and practices, and (3) updated the submission, appeal writing, and planning procedures for PA. Metrics were compared at the following 3 time points: 6 months before, at phase-in, and at 6 months after intervention.</p><p><strong>Results: </strong>In analyzing the impact of improving PA access to care, the percentage of approvals for commercial proton beam therapy improved by an absolute 30.6% postintervention (<i>P</i> < .001). The proportion of commercially insured patients treated with proton beam therapy also increased by 6.2%, and the number of new starts rose by 11.7 patients/mo. Overall patient census increased by 13 patients/d. Median authorization time was 1 week, and 90% of surveyed providers reported reduced PA burden and improved patient care.</p><p><strong>Conclusion: </strong>This is the first validated, comprehensive operational strategy to improve access to cancer therapy while reducing the burden of PA. This novel approach may be helpful for addressing barriers to PA in medical and surgical oncology because the redesign is predicated on laws that regulate PA across disciplines.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"1 1","pages":"65-72"},"PeriodicalIF":1.7,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44242671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Specific Quality Assurance in Pencil Beam Scanning by 2-Dimensional Array","authors":"Nuttida Rawiwan, Nichakan Chatchumnan, Mananchaya Vimolnoch, Sakda Kingkaew, Sornjarod Oonsiri","doi":"10.14338/ijpt-23-00016.1","DOIUrl":"https://doi.org/10.14338/ijpt-23-00016.1","url":null,"abstract":"Purpose: This study aimed to determine the characteristics of 2D ionization chamber array and the confidence limits of the gamma passing rate in pencil beam scanning proton therapy. Materials and Methods: The Varian ProBeam Compact spot-scanning system and the PTW OCTAVIUS 1500XDR array were used as a proton therapy system and detector, respectively. Our methods consisted of 2 parts: (1) the characteristics of the detector were tested and (2) patient-specific quality assurance was performed and evaluated by gamma analysis using dose-difference and distance-to-agreement criteria of 3% and 2 mm, respectively, with 123 treatment plans in head and neck, breast, chest, abdomen, and pelvic regions. Results: The PTW OCTAVIUS 1500XDR array had good reproducibility, uniformity, linearity, repetition rate, and monitor unit per spot within 0.1%, with accuracy, energy dependence, and measurement depth within 0.5%. The overall uncertainty of the PTW OCTAVIUS 1500XDR array was 2.49%. For field size and range shifter, using gamma analysis, the passing rate was 100%. The overall results of patient-specific quality assurance with the gamma evaluation were 98.9% ± 1.6% in 123 plans and confidence limit was 95.7%. Conclusion: The PTW OTAVIUS 1500XDR offered effective performance in pencil beam scanning proton therapy.","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" 35","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135341094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing the Role of Proton Therapy for Spine Metastases Through Diagnostic Scan–Based Planning","authors":"Cameron W. Swanick, Michael H. Shang, Kevin Erhart, Jonathan Cabrera, James Burkavage, Tomas Dvorak, Naren Ramakrishna, Zhiqiu Li, Amish Shah, Sanford L. Meeks, Omar A. Zeidan, Patrick Kelly","doi":"10.14338/ijpt-23-00005.1","DOIUrl":"https://doi.org/10.14338/ijpt-23-00005.1","url":null,"abstract":"Abstract Purpose: Many patients with metastatic cancer live years beyond diagnosis, and there remains a need to improve the therapeutic ratio of metastasis-directed radiation for these patients. This study aimed to assess a process for delivering cost-effective palliative proton therapy to the spine using diagnostic scan–based planning (DSBP) and prefabricated treatment delivery devices. Materials and Methods: We designed and characterized a reusable proton aperture system that adjusts to multiple lengths for spine treatment. Next, we retrospectively identified 10 patients scan treated with thoracic proton therapy who also had a diagnostic computed tomography within 4 months of simulation. We contoured a T6-T9 target volume on both the diagnostic scans (DS) and simulation scans (SS). Using the aperture system, we generated proton plans on the DS using a posterior–anterior beam with no custom range compensator to treat T6-T9 to 8 Gy × 1. Plans were transferred to the SS to compare coverage and normal tissue doses, followed by robustness analysis. Finally, we compared normal tissue doses and costs between proton and photon plans. Results were compared using the Wilcoxon signed-rank test. Results: Median D95% on the DS plans was 101% (range, 100%–102%) of the prescription dose. Median Dmax was 107% (range, 105%–108%). When transferred to SS, coverage and hot spots remained acceptable for all cases. Heart and esophagus doses did not vary between the DS and SS proton plans (P &amp;gt;.2). Robustness analysis with 5 mm X/Y/Z shifts showed acceptable coverage (D95% &amp;gt; 98%) for all cases. Compared with the proton plans, the mean heart dose was higher for both anterior–posterior/posterior–anterior and volumetric modulated arc therapy plans (P &amp;lt; .01). Cost for proton DSBP was comparable to more commonly used photon regimens. Conclusion: Proton DSBP is technically feasible and robust, with superior sparing of the heart compared with photons. Eliminating simulation and custom devices increases the value of this approach in carefully selected patients.","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" 91","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135340491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceedings to the 61st Annual Conference of the Particle Therapy Cooperative Group","authors":"","doi":"10.14338/ijpt-23-ptcog61-10.2","DOIUrl":"https://doi.org/10.14338/ijpt-23-ptcog61-10.2","url":null,"abstract":"","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"76 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135868300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}