Online learning in proton radiation therapy: the future in the post-Covid-19 pandemic era?

Objective: The Covid-19 pandemic placed unprecedented strain on medical education and led to a vast increase in online learning. Subsequently, the XXXX International Proton School moved from face-to-face to online. Delegate feedback and current literature were studied to determine benefits, challenges, and potential solutions, for online proton therapy education. Methods: The course was converted to a six-week online course with twice weekly two-hour sessions. Feedback was studied pre, during, and post course regarding demographics, learning objectives, proton therapy knowledge, ease of engagement, technical difficulties, and course format. Statistical analyses were performed for proton therapy knowledge pre and post course. Results: An increase in delegate attendance was seen with increased international and multidisciplinary diversity. Learner objectives included treatment planning, clinical applications, physics, and centre development. Average learner reported scores of confidence in proton therapy knowledge improved significantly from 3, some knowledge, to 4, adequate knowledge after the course (p<0.0001). There were minimal reported difficulties using the online platform, good reported learner engagement, and shorter twice weekly sessions were reported conducive for learning. Recordings for asynchronous learning addressed time zone difficulties. Conclusions: The obligatory switch to online platforms has catalysed a paradigm shift towards online learning with delegates reporting educational benefit. We propose solutions to challenges of international online education, and a pedagogical model for online proton therapy education. Advances in knowledge: Online education is an effective method to teach proton therapy to international audiences. The future of proton education includes a hybrid of online and practical face-to-face learning depending on the level of cognitive skill required.

Efficacy and Safety of Proton Therapy for Medulloblastoma Patients: A Mata-Analysis

Background: Currently, photon therapy is mainly used for radiotherapy, however, the long-term side effects of photon therapy are sometimes reported, especially in children, including cognitive decline, mental decline, growth retardation, endocrine dysfunction and secondary tumor.Compared with photon radiotherapy, proton therapy is a novel method of radiation therapy, which reduces acute and late radiation damage and improves patients’ quality of life. Therefore, we evaluated proton therapy on medulloblastoma patients by meta-analysis in this study. Materials and Methods: A clinical randomized controlled trial was conducted by retrieving the main databases PubMed (Medline), EMbase, Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese Zhi-wang (CNKI), Wanfang Database, and VIP Database. We analyzed the literature which matched the quality criteria for the prognostic impact of proton and photon therapy on medulloblastoma patients. Results: Ten articles were included in this study. The overall survival (OS) rate and side effects were comprehensively analyzed. The results showed that proton radiotherapy significantly reduced the side effects and recurrence rate of tumor. Conclusion: Proton therapy could significantly reduce the side effects and recurrence rate of medulloblastoma in patients.

Post-Irradiation Sinus Mucosa Disease in Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Proton Therapy

In the past decade, patients with nasopharyngeal cancer (NPC) have been deemed candidates for proton radiotherapy, due to the large and comprehensive target volumes and the necessity for the retention of the surrounding healthy tissues. In this study, we aimed to compare the incidence and severity of post-irradiation sinusitis by detecting sinus mucosa diseases (SMDs) via the magnetic resonance imaging (MRI) of patients with NPC after intensity-modulated proton therapy (IMPT) and volume-modulated arc therapy (VMAT). A total of 53 patients in the IMPT group and 54 patients in the VMAT group were enrolled in this study. There were significantly lower endoscopic scores and Lund–Mackay staging scores determined from MRI scans in the IMPT group during different follow-up periods. For the most vulnerable sinuses, the incidence and severity of SMD were the highest during the third post-radiotherapy month in both groups. These decreased steadily, and there was no significant increase in the incidence and severity of SMD during the second post-radiotherapy year in the IMPT group. Our data show that NPC patients with IMPT have a significantly lower incidence and decreased severity of SMD than those with VMAT. A better and faster recovery of sinonasal function after radiotherapy in the IMPT group was also observed.