Consensus guidelines for implementing pencil-beam scanning proton therapy for thoracic malignancies on behalf of the PTCOG Thoracic and Lymphoma Subcommittee Journal Article
| Authors: | Chang, J. Y.; Zhang, X.; Knopf, A.; Li, H.; Mori, S.; Dong, L.; Lu, H. M.; Liu, W.; Badiyan, S. N.; Both, S.; Meijers, A.; Lin, L.; Flampouri, S.; Li, Z.; Umegaki, K.; Simone, C. B. 2nd; Zhu, X. R. |
| Article 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. © 2017 The Authors |
| Keywords: | intensity modulated radiation therapy; tumor volume; patient monitoring; practice guideline; pathology; diagnostic imaging; thoracic neoplasms; computerized tomography; radiotherapy, intensity-modulated; tumor burden; quality assurance; total quality management; practice guidelines as topic; lung; critical structures; breath holding; respiration; esophagus; quality improvement; optimization; uncertainty; breathing; proton therapy; movement; movement (physiology); intensity-modulated; procedures; organs at risk; four dimensional computed tomography; four-dimensional computed tomography; humans; human; technical challenges; proton beams; thoracic malignancies; nuclear instrumentation; adaptive planning; reducing treatment; robust optimization; proton beam therapy; simulation training |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 99 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2017-09-01 |
| Start Page: | 41 |
| End Page: | 50 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2017.05.014 |
| PUBMED: | 28816159 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Export Date: 5 September 2017 -- Source: Scopus |
