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

Joe Y. Chang*, Xiaodong Zhang, Antje Knopf, Heng Li, Shinichiro Mori, Lei Dong, Hsiao-Ming Lu, Wei Liu, Shahed N. Badiyan, Stephen Both, Arturs Meijers, Liyong Lin, Stella Flampouri, Zuofeng Li, Kikuo Umegaki, Charles B. Simone, Xiaorong R. Zhu

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

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    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 tomographye 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. (C) 2017 The Authors. Published by Elsevier Inc.

    Original languageEnglish
    Pages (from-to)41-50
    Number of pages10
    JournalInternational Journal of Radiation Oncology Biology Physics
    Volume99
    Issue number1
    DOIs
    Publication statusPublished - 1-Sep-2017

    Keywords

    • CELL LUNG-CANCER
    • POLYMER GEL DOSIMETER
    • MOTION MITIGATION
    • RESPIRATORY MOTION
    • PARTICLE THERAPY
    • ROBUST OPTIMIZATION
    • RADIATION-THERAPY
    • MOVING TARGETS
    • TUMOR MOTION
    • TREATMENT UNCERTAINTIES

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