Recent Advances in Particle Therapy for Cancers

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 4482

Special Issue Editors


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Guest Editor
Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA
Interests: particle therapy; computational medical physics

E-Mail Website
Guest Editor
Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA
Interests: particle therapy; quality control; beam delivery control and simulation

Special Issue Information

Dear Colleagues,

Particle therapy was first used at the Lawrence Berkeley National Laboratory more than 50 years ago. After that program closed, particle therapy moved to Japan in 1994 and later Germany in 2002. Currently, there are 13 operational facilities, with a few more under construction.

In this Special Issue, we will focus on three key aspects of particle therapy:

  1. Physics and technology: recent advancements in technology, including but not limited to accelerators, imaging, detectors, and computational capabilities, and the advancements they have led to in particle therapy;
  2. Radiation biology: the radiobiological advantage of particle therapy, which comes from its high LET and leads to direct and clustered DNA damage and a large relative biological effectiveness (RBE). In addition, specific biological mechanisms that make particle therapy especially suitable for tumors that are radiation-resistant and/or hypoxic and which mean that it has great potential for inducing therapeutic immune responses;
  3. Clinical outcomes: knowledge stemming from the approximately 50,000 patients who have been treated with CIRT in the past three decades, as well as the Phase I/II trials that have been carried out in Japan and Europe over the years and which show negligible toxicity while simultaneously showing great tumor control for a wide variety of treatment sites, including but not limited to bone and soft tissue sarcomas, adenocarcinoma, and malignant melanoma. 

Dr. Chris J. Beltran
Dr. Keith Furutani
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Keywords

  • radiation biology
  • radiation oncology
  • computational biology
  • high LET
  • microdosimetry
  • Monte Carlo
  • biological modeling
  • in silico commissioning beam performance
  • medical physics
  • quality assurance/control
  • realtime imaging
  • cone beam
  • computed tomography
  • novel beam delivery

Published Papers (3 papers)

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Research

12 pages, 1581 KiB  
Article
Selecting Optimal Proton Pencil Beam Scanning Plan Parameters to Reduce Dose Discrepancy between Discrete Spot Plan and Continuous Scanning: A Proof-of-Concept Study
by Xiaoying Liang, Chris J. Beltran, Chunbo Liu, Chunjoo Park, Bo Lu, Sridhar Yaddanapudi, Jun Tan and Keith M. Furutani
Cancers 2023, 15(16), 4084; https://doi.org/10.3390/cancers15164084 - 13 Aug 2023
Viewed by 744
Abstract
Pencil beam scanning delivered with continuous scanning has several advantages over conventional discrete spot scanning. Such advantages include improved beam delivery efficiency and reduced beam delivery time. However, a move dose is delivered between consecutive spots with continuous scanning, and current treatment planning [...] Read more.
Pencil beam scanning delivered with continuous scanning has several advantages over conventional discrete spot scanning. Such advantages include improved beam delivery efficiency and reduced beam delivery time. However, a move dose is delivered between consecutive spots with continuous scanning, and current treatment planning systems do not take this into account. Therefore, continuous scanning and discrete spot plans have an inherent dose discrepancy. Using the operating parameters of the state-of-the-art particle therapy system, we conducted a proof-of-concept study in which we systematically generated 28 plans for cubic targets with different combinations of plan parameters and simulated the dose discrepancies between continuous scanning and a planned one. A nomograph to guide the selection of plan parameters was developed to reduce the dose discrepancy. The effectiveness of the nomograph was evaluated with two clinical cases (one prostate and one liver). Plans with parameters guided by the nomograph decreased dose discrepancy than those used standard plan parameters. Specifically, the 2%/2 mm gamma passing rate increased from 96.3% to 100% for the prostate case and from 97.8% to 99.7% for the liver case. The CTV DVH root mean square error decreased from 2.2% to 0.2% for the prostate case and from 1.8% to 0.9% for the liver case. The decreased dose discrepancy may allow the relaxing of the delivery constraint for some cases, leading to greater benefits in continuous scanning. Further investigation is warranted. Full article
(This article belongs to the Special Issue Recent Advances in Particle Therapy for Cancers)
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13 pages, 1982 KiB  
Article
Patient Breathing Motion and Delivery Specifics Influencing the Robustness of a Proton Pancreas Irradiation
by Barbara Knäusl, Franciska Lebbink, Piero Fossati, Erik Engwall, Dietmar Georg and Markus Stock
Cancers 2023, 15(9), 2550; https://doi.org/10.3390/cancers15092550 - 29 Apr 2023
Cited by 5 | Viewed by 1483
Abstract
Motion compensation strategies in particle therapy depend on the anatomy, motion amplitude and underlying beam delivery technology. This retrospective study on pancreas patients with small moving tumours analysed existing treatment concepts and serves as a basis for future treatment strategies for patients with [...] Read more.
Motion compensation strategies in particle therapy depend on the anatomy, motion amplitude and underlying beam delivery technology. This retrospective study on pancreas patients with small moving tumours analysed existing treatment concepts and serves as a basis for future treatment strategies for patients with larger motion amplitudes as well as the transition towards carbon ion treatments. The dose distributions of 17 hypofractionated proton treatment plans were analysed using 4D dose tracking (4DDT). The recalculation of clinical treatment plans employing robust optimisation for mitigating different organ fillings was performed on phased-based 4D computed tomography (4DCT) data considering the accelerator (pulsed scanned pencil beams delivered by a synchrotron) and the breathing-time structure. The analysis confirmed the robustness of the included treatment plans concerning the interplay of beam and organ motion. The median deterioration of D50%D50%) for the clinical target volume (CTV) and the planning target volume (PTV) was below 2%, while the only outlier was observed for ΔD98% with −35.1%. The average gamma pass rate over all treatment plans (2%/ 2 mm) was 88.8% ± 8.3, while treatment plans for motion amplitudes larger than 1 mm performed worse. For organs at risk (OARs), the median ΔD2% was below 3%, but for single patients, essential changes, e.g., up to 160% for the stomach were observed. The hypofractionated proton treatment for pancreas patients based on robust treatment plan optimisation and 2 to 4 horizontal and vertical beams showed to be robust against intra-fractional movements up to 3.7 mm. It could be demonstrated that the patient’s orientation did not influence the motion sensitivity. The identified outliers showed the need for continuous 4DDT calculations in clinical practice to identify patient cases with more significant deviations. Full article
(This article belongs to the Special Issue Recent Advances in Particle Therapy for Cancers)
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14 pages, 1484 KiB  
Article
Rotating Gantries Provide Individualized Beam Arrangements for Charged Particle Therapy
by Siven Chinniah, Amanda J. Deisher, Michael G. Herman, Jedediah E. Johnson, Anita Mahajan and Robert L. Foote
Cancers 2023, 15(7), 2044; https://doi.org/10.3390/cancers15072044 - 29 Mar 2023
Cited by 1 | Viewed by 1736
Abstract
Purpose: This study evaluates beam angles used to generate highly individualized proton therapy treatment plans for patients eligible for carbon ion radiotherapy (CIRT). Methods and Materials: We retrospectively evaluated patients treated with pencil beam scanning intensity modulated proton therapy from 2015 to 2020 [...] Read more.
Purpose: This study evaluates beam angles used to generate highly individualized proton therapy treatment plans for patients eligible for carbon ion radiotherapy (CIRT). Methods and Materials: We retrospectively evaluated patients treated with pencil beam scanning intensity modulated proton therapy from 2015 to 2020 who had indications for CIRT. Patients were treated with a 190° rotating gantry with a robotic patient positioning system. Treatment plans were individualized to provide maximal prescription dose delivery to the tumor target volume while sparing organs at risk. The utilized beam angles were grouped, and anatomic sites with at least 10 different beam angles were sorted into histograms. Results: A total of 467 patients with 484 plans and 1196 unique beam angles were evaluated and characterized by anatomic treatment site and the number of beam angles utilized. The most common beam angles used were 0° and 180°. A wide range of beam angles were used in treating almost all anatomic sites. Only esophageal cancers had a predominantly unimodal grouping of beam angles. Pancreas cancers showed a modest grouping of beam angles. Conclusions: The wide distribution of beam angles used to treat CIRT-eligible patients suggests that a rotating gantry is optimal to provide highly individualized beam arrangements. Full article
(This article belongs to the Special Issue Recent Advances in Particle Therapy for Cancers)
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