scholarly journals Proton therapy – An evolving technology

2017 ◽  
Vol 3 (4) ◽  
Author(s):  
Antonio Cassio Assis Pellizzon
Keyword(s):  
Proton Therapy ◽  
Font Size ◽  
Number Of Patients ◽  
Radiotherapy Techniques

<p>In the last 25 years, more effective chemotherapy, better surgical and radiotherapy techniques have contributed, at least in part, to improvement in control for most cancers, also increasing the number of patients referred for a second course of radiation<span style="font-size: 8.33333px;">.</span></p>

scholarly journals Feasibility of transrectal and transperineal fiducial marker placement for prostate cancer before proton therapy

2020 ◽  
Author(s):  
Kengo Ohta ◽  
Hiroyuki Ogino ◽  
Hiromitsu Iwata ◽  
Shingo Hashimoto ◽  
Yukiko Hattori ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Proton Therapy ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Fiducial Marker ◽  
Success Rates ◽  
Migration Rates ◽  
Pain Scores ◽  
Number Of Patients ◽  
Lower Pain

Abstract Background To compare the feasibility of transrectal and transperineal fiducial marker placement for prostate cancer before proton therapy. Materials and Methods From 2013 to 2015, the first 40 prostate cancer patients that were scheduled for proton therapy underwent transrectal fiducial marker placement, and the next 40 patients underwent transperineal fiducial marker placement (the first series). Technical and clinical success and pain scores were evaluated. In the second series (n = 280), the transrectal or transperineal approach was selected depending on the presence/absence of comorbidities, such as blood coagulation abnormalities. Seven patients refused to undergo the procedure. Thus, the total number of patients across both series was 353 (262 and 91 underwent the transrectal and transperineal approach, respectively). Technical and clinical success, complications, marker migration and the distance between the two markers were evaluated. Results In the first series, the technical and clinical success rates were 100% in both groups. The transrectal group exhibited lower pain scores than the transperineal group. The overall technical success rates of the transrectal and transperineal groups were 100% (262/262) and 99% (90/91), respectively (P &gt; 0.05). The overall clinical success rate was 100% in both groups, and there were no major complications in either group. The migration rates of the two groups did not differ significantly. The mean distance between the two markers was 25.6 ± 7.1 mm (mean ± standard deviation) in the transrectal group and 31.9 ± 5.2 mm in the transperineal group (P &lt; 0.05). Conclusion Both the transrectal and transperineal fiducial marker placement methods are feasible and safe.

Proton Accelerators for Radiation Therapy

2019 ◽  
pp. 11-22 ◽  
Author(s):  
А. Черняев ◽  
A. Chernyaev ◽  
Г. Кленов ◽  
G. Klenov2 ◽  
Андрей Бушманов ◽  
...  
Keyword(s):  
Proton Therapy ◽  
Statistical Data ◽  
The United States ◽  
Annual Number ◽  
High Tech ◽  
Extensive Experience ◽  
Number Of Patients ◽  
The World ◽  
New Ideas

Purpose: To make an analysis (including statistical data) of accelerator equipment for proton therapy (PT) in Russia and the world; to identify the main trends and directions of development in this area. Material and methods: Currently, proton therapy is developing rapidly in the world. Every year new proton centers are built. The number of commercial companies and research institutes, that are included in this high-tech sector, grows every year. Physicists and doctors together actively develop and introduce new ideas and technologies that are able to increase the efficiency and quality of proton therapy and also make it less costly. This review is an analysis of both publications in refereed publications, and reports made at relevant conferences and seminars. In addition, the data presented in the review are based on the information from the companies-manufacturers of equipment for proton therapy, which is open or provided for non-commercial use, with an indication of the sources. Results: In recent years, the main trends in the development of accelerators for proton therapy are: reducing the size and weight of machines, using of active pencil scanning as a standard method of dose delivering, reducing the time spent by patients in treatment rooms, using modulated radiation intensity in proton therapy. There is a transition from the construction of multi-cabin PT centers with an annual number of patients about 1000 people (due to their high cost and need to have an infrastructure for such big number of patients), to the creation of small-sized single-cabin complexes with an annual flow of several hundred people. Conclusion: Despite proton therapy has a good promotion and popularization activities, it is still an inaccessible method for most cancer patients with the exception of the United States, Japan and Europe. The lack of PT centers, the price per course of treatment, the lack of specialists in this area, and the attitude of most clinicians to PT as an experimental method of treatment is acute. In Russia, proton therapy does not receive enough support, despite the enormous potential and extensive experience that has been used for half a century of using PT. The last open proton center is private, and the only local manufacturer of equipment for PT exists only thanks to foreign contracts. Nevertheless, research and development continues. Moreover, the development is equal to the level of leading countries.

scholarly journals Radiation therapy services during the COVID-19 pandemic

2021 ◽  
Vol 60 (2) ◽  
pp. 22-24
Author(s):  
Y. I. Ishkinin ◽  
R. Z. Ibrayev ◽  
R. B. Raimbekov ◽  
K. D. Datbayev ◽  
R. U. Akhunova ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
High Tech ◽  
Average Amount ◽  
Conformal Radiation Therapy ◽  
Image Guided Radiation Therapy ◽  
Number Of Patients ◽  
Therapy Services ◽  
Radiotherapy Techniques ◽  
Oncology Center ◽  
Complex Methods

Relevance: The outbreak of a new respiratory disease SARS CoV-2 (COVID-19), reported by China in December 2019, significantly impacted cancer treatment. However, modern radiotherapy techniques remain in use during the COVID-19 pandemics. They include intensive modulated radiation therapy (IMRT, VMAT), image-guided radiation therapy (IGRT), stereotactic radiosurgery, and radiotherapy (SRS and SRT). The research aimed to compare the techniques used and the throughput of the linear accelerator before and during the COVID-19 pandemics. Results: The results were measured during nine months of operation of Almaty Oncology Center before the pandemic (April-December 2019) and the similar period during the pandemic in 2020. The amount of high-tech radiotherapy services provided before and during the COVID-19 pandemic equaled to (amount of sessions/ number of patients): conformal (3D) radiotherapy – 6510/335 vs. 6005/286; IGRT – 9171/524 and 8977/551; IMRT and VMAT – 4208/190 vs. 5992/287. The share of more complex methods of radiation therapy (IMRT, VMAT) has increased from 39.3% of sessions before the COVID-19 pandemic to 49.9% during the pandemic. The number of SRS and SRT procedures performed/patients served has also increased from 14/6 to 47/13. The average amount of services per patient before and during the COVID-19 pandemic has changed as follows: conformal radiation therapy – from 19.4 sessions to 21.0, IMRT and VMAT – from 22.1 to 20.9, IGRT – from 17.5 to 16.3. Conclusion: During the COVID-19 pandemic, there was no decrease in the amount of radiotherapy services provided; the use of more high-tech radiotherapy techniques has increased 1.4 times.

A pilot study of proton beam theary for mucosal melanoma of the head and neck

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17042-e17042
Author(s):  
S. Zenda ◽  
M. Kawashima ◽  
R. Kohno ◽  
S. Arahira ◽  
T. Nishio ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Beam ◽  
Proton Therapy ◽  
Progression Free Survival ◽  
Late Toxicity ◽  
Distant Metastases ◽  
Proton Beam Therapy ◽  
Mucosal Melanoma ◽  
Cervical Lymph Nodes ◽  
Number Of Patients

e17042 Background: The aim of this study is to clarify the clinical profile of proton beam therapy for mucosal melanoma of the head and neck. Methods: Patients with mucosal melanoma of the head and neck fulfilling the following criteria were enrolled: histologically confirmed malignant melanoma; N0 and M0 disease. Proton therapy was delivered three times a week with planned total dose of 60 GyE in 15 fractions. Results: From January 2004 through January 2007, thirteen patients were enrolled in this study. Patients’ characteristics were as follows: median age, 75 years (range, 56 to 79); male/female, 7/6; T1/2/3/4/rec, 3/2/0/7/1. All could receive the full dose of proton therapy. The most common acute toxicities were mucositis (grade 3: 15%) and dermatitis (grade 2: 15%). One patient had unilateral impairment of visual acuity possibly related with treatment. Initial local control rate was 77.0% (10/13, 95%CI: 46.2–95.0%). With median follow up period of 33.7 months, median progression free survival was 18.9 months and median survival time was not reached. 2-year overall survival rate was 69.7% (95%CI: 31.6–86.1%). Most frequent site of first failure was cervical lymph nodes outside of PTV. Four patients died of disease; cachexia caused by distant metastases in three and carotid blowout because of nodal disease in one. Conclusions: Proton beam therapy for mucosal melanoma of the head and neck achieved favorable results in this limited number of patients, although further investigation about late toxicity is needed. Now, the phase II study of this treatment is ongoing. No significant financial relationships to disclose.

scholarly journals Radiation therapy services during the COVID-19 pandemic

2021 ◽  
Vol 60 (2) ◽  
pp. 22-24
Author(s):  
Y. I. Ishkinin ◽  
R. Z. Ibrayev ◽  
R. B. Raimbekov ◽  
K. D. Datbayev ◽  
R. U. Akhunova ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
High Tech ◽  
Average Amount ◽  
Conformal Radiation Therapy ◽  
Image Guided Radiation Therapy ◽  
Number Of Patients ◽  
Therapy Services ◽  
Radiotherapy Techniques ◽  
Oncology Center ◽  
Complex Methods

Relevance: The outbreak of a new respiratory disease SARS CoV-2 (COVID-19), reported by China in December 2019, significantly impacted cancer treatment. However, modern radiotherapy techniques remain in use during the COVID-19 pandemics. They include intensive modulated radiation therapy (IMRT, VMAT), image-guided radiation therapy (IGRT), stereotactic radiosurgery, and radiotherapy (SRS and SRT). The research aimed to compare the techniques used and the throughput of the linear accelerator before and during the COVID-19 pandemics. Results: The results were measured during nine months of operation of Almaty Oncology Center before the pandemic (April-December 2019) and the similar period during the pandemic in 2020. The amount of high-tech radiotherapy services provided before and during the COVID-19 pandemic equaled to (amount of sessions/ number of patients): conformal (3D) radiotherapy – 6510/335 vs. 6005/286; IGRT – 9171/524 and 8977/551; IMRT and VMAT – 4208/190 vs. 5992/287. The share of more complex methods of radiation therapy (IMRT, VMAT) has increased from 39.3% of sessions before the COVID-19 pandemic to 49.9% during the pandemic. The number of SRS and SRT procedures performed/patients served has also increased from 14/6 to 47/13. The average amount of services per patient before and during the COVID-19 pandemic has changed as follows: conformal radiation therapy – from 19.4 sessions to 21.0, IMRT and VMAT – from 22.1 to 20.9, IGRT – from 17.5 to 16.3. Conclusion: During the COVID-19 pandemic, there was no decrease in the amount of radiotherapy services; the use of more high-tech radiotherapy techniques has increased 1.4 times.

Number of patients potentially eligible for proton therapy

2005 ◽  
Vol 44 (8) ◽  
pp. 836-849 ◽  
Author(s):  
Bengt Glimelius ◽  
Anders Ask ◽  
Göran Bjelkengren ◽  
Thomas Björk-Eriksson ◽  
Erik Blomquist ◽  
...  
Keyword(s):  
Proton Therapy ◽  
Number Of Patients

scholarly journals The Potential Role of Intensity-Modulated Proton Therapy in Hepatic Carcinoma in Mitigating the Risk of Dose De-Escalation

2020 ◽  
Vol 19 ◽  
pp. 153303382098041
Author(s):  
Luca Cozzi ◽  
Tiziana Comito ◽  
Mauro Loi ◽  
Antonella Fogliata ◽  
Ciro Franzese ◽  
...  
Keyword(s):  
At Risk ◽  
Proton Therapy ◽  
Organs At Risk ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated ◽  
Number Of Patients ◽  
Target Volumes ◽  
Dosimetric Analysis

Purpose: To investigate the role of intensity-modulated proton therapy (IMPT) for hepatocellular carcinoma (HCC) patients to be treated with stereotactic body radiation therapy (SBRT) in a risk-adapted dose prescription regimen. Methods: A cohort of 30 patients was retrospectively selected as “at-risk” of dose de-escalation due to the proximity of the target volumes to dose-limiting healthy structures. IMPT plans were compared to volumetric modulated arc therapy (VMAT) RapidArc (RA) plans. The maximum dose prescription foreseen was 75 Gy in 3 fractions. The dosimetric analysis was performed on several quantitative metrics on the target volumes and organs at risk to identify the relative improvement of IMPT over VMAT and to determine if IMPT could mitigate the need of dose reduction and quantify the consequent potential patient accrual rate for protons. Results: IMPT and VMAT plans resulted in equivalent target dose distributions: both could ensure the required coverage for CTV and PTV. Systematic and significant improvements were observed with IMPT for all organs at risk and metrics. An average gain of 9.0 ± 11.6, 8.5 ± 7.7, 5.9 ± 7.1, 4.2 ± 6.4, 8.9 ± 7.1, 6.7 ± 7.5 Gy was found in the near-to-maximum doses for the ribs, chest wall, heart, duodenum, stomach and bowel bag respectively. Twenty patients violated one or more binding constraints with RA, while only 2 with IMPT. For all these patients, some dose de-intensification would have been required to respect the constraints. For photons, the maximum allowed dose ranged from 15.0 to 20.63 Gy per fraction while for the 2 proton cases it would have been 18.75 or 20.63 Gy. Conclusion: The results of this in-silico planning study suggests that IMPT might result in advantages compared to photon-based VMAT for HCC patients to be treated with ablative SBRT. In particular, the dosimetric characteristics of protons may avoid the need for dose de-escalation in a risk-adapted prescription regimen for those patients with lesions located in proximity of dose-limiting healthy structures. Depending on the selection thresholds, the number of patients eligible for treatment at the full dose can be significantly increased with protons.

scholarly journals Clinical utilization of radiation therapy in Korea, 2016

2020 ◽  
Vol 61 (2) ◽  
pp. 249-256
Author(s):  
Eunji Kim ◽  
Won Il Jang ◽  
Mi-Sook Kim ◽  
Eun Kyung Paik ◽  
Hee Jin Kim ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Proton Therapy ◽  
Specific Treatment ◽  
Intensity Modulated Radiotherapy ◽  
Nationwide Survey ◽  
Treatment Modalities ◽  
Utilization Rate ◽  
Stereotactic Radiation ◽  
Clinical Utilization ◽  
Number Of Patients

Abstract Radiotherapy (RT) is one of the primary cancer treatment modalities. To estimate the actual utilization of RT and infrastructure in Korea, the current study was performed. Data from 2012 to 2016 were extracted from the Health Insurance Review and Assessment Service. In addition, a nationwide survey was conducted to collect the statistics of RT facilities, equipment and human resources in Korea. The total number of patients treated with RT was 72 563 in 2016. The five cancers that were most commonly treated with RT in 2016 were breast, lung, colorectal, liver and prostate cancer. According to analyses of specific treatment modalities, the number of patients treated with intensity-modulated radiotherapy (IMRT), stereotactic radiation therapy (SRT) and proton therapy increased from 6670, 6306 and 50 in 2012 to 21584, 9048 and 703 in 2016, respectively. Ninety radiation oncology centers were working in 2015 and there were a total of 213 megavoltage teletherapy machines. In 2015, 310 patients were treated per megavoltage RT machine, 246 patients per radiation oncologist, 501 patients per medical physicist and 111 patients per radiotherapy technologist. In conclusion, the number of patients who underwent RT in Korea has increased steadily from 2012 to 2016. The IMRT utilization rate remarkably increased in 2016, and the number of patients treated with advanced treatment modalities such as IMRT, SRT and proton therapy is expected to increase.

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