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Cancers
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Advances in Particle Therapy for Cancer Treatment and Research
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Advances in Particle Therapy for Cancer Treatment and Research

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (15 September 2024) | Viewed by 6341

Special Issue Editor

Dr. Boon-Keng Kevin Teo

E-Mail Website
Guest Editor
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
Interests: proton imaging; dual-energy CT; FLASH

Special Issue Information

Dear Colleagues,

The dosimetric advantage afforded by high-energy particles, such as protons and Carbon ions, over conventional X-ray radiation has led to particle therapy being increasingly adopted for the treatment of many types of cancers. Clinical proton delivery technology is now mature enough that many standalone single-room proton centers can be reliably operated outside of major academic hospital facilities. This growth in the number of particle delivery centers came at a time of transition from passively scattered beams to a scanned pencil beam, which has further improved the dosimetric characteristics of particle therapy.

Recent advances in particle therapy have focused on reducing delivery uncertainties, such as development of in vivo imaging and adoption of dual-energy CT for stopping power calculation. To manage the effects of motion, 4D optimization and delivery techniques have been adopted. Plan optimization that incorporates radiobiological effects using parameters such as linear energy transfer is now feasible. On the treatment delivery front, proton arc therapy has been proposed as a method to optimize potential radiobiological effects while ultra-high-dose-rate delivery, also known as FLASH, is under active investigation for potential increased normal tissue dose-sparing effect. The field of artificial intelligence methods in radiotherapy is currently making rapid progress. Novel applications, such as dose prediction, quality assurance and plan optimization, will start to be applied towards particle therapy in the near future. As particle therapy becomes even more mature, some of these advances will become routine while others will fade only to have new ones emerge. This Special Issue will highlight some of these advances in the hope that they will eventually be adopted in particle therapy treatments of the future.

Dr. Boon-Keng Kevin Teo
Guest Editor

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 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

  • particle therapy
  • FLASH
  • LET
  • adaptive therapy
  • in vivo imaging
  • adaptive therapy
  • range verification
  • robust optimization

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Published Papers (3 papers)

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12 pages, 1791 KiB  
Article
Pencil Beam Scanning Proton Bragg Peak Conformal FLASH in Prostate Cancer Stereotactic Body Radiotherapy
by Tyler Kaulfers, Grant Lattery, Chingyun Cheng, Xingyi Zhao, Balaji Selvaraj, Hui Wu, Arpit M. Chhabra, Jehee Isabelle Choi, Haibo Lin, Charles B. Simone II, Shaakir Hasan, Minglei Kang and Jenghwa Chang
Cancers 2024, 16(4), 798; https://doi.org/10.3390/cancers16040798 - 15 Feb 2024
Cited by 4 | Viewed by 2297
Abstract
Bragg peak FLASH radiotherapy (RT) uses a distal tracking method to eliminate exit doses and can achieve superior OAR sparing. This study explores the application of this novel method in stereotactic body radiotherapy prostate FLASH-RT. An in-house platform was developed to enable intensity-modulated [...] Read more.
Bragg peak FLASH radiotherapy (RT) uses a distal tracking method to eliminate exit doses and can achieve superior OAR sparing. This study explores the application of this novel method in stereotactic body radiotherapy prostate FLASH-RT. An in-house platform was developed to enable intensity-modulated proton therapy (IMPT) planning using a single-energy Bragg peak distal tracking method. The patients involved in the study were previously treated with proton stereotactic body radiotherapy (SBRT) using the pencil beam scanning (PBS) technique to 40 Gy in five fractions. FLASH plans were optimized using a four-beam arrangement to generate a dose distribution similar to the conventional opposing beams. All of the beams had a small angle of two degrees from the lateral direction to increase the dosimetry quality. Dose metrics were compared between the conventional PBS and the Bragg peak FLASH plans. The dose rate histogram (DRVH) and FLASH metrics of 40 Gy/s coverage (V40Gy/s) were investigated for the Bragg peak plans. There was no significant difference between the clinical and Bragg peak plans in rectum, bladder, femur heads, large bowel, and penile bulb dose metrics, except for Dmax. For the CTV, the FLASH plans resulted in a higher Dmax than the clinical plans (116.9% vs. 103.3%). For the rectum, the V40Gy/s reached 94% and 93% for 1 Gy dose thresholds in composite and single-field evaluations, respectively. Additionally, the FLASH ratio reached close to 100% after the application of the 5 Gy threshold in composite dose rate assessment. In conclusion, the Bragg peak distal tracking method can yield comparable plan quality in most OARs while preserving sufficient FLASH dose rate coverage, demonstrating that the ultra-high dose technique can be applied in prostate FLASH SBRT. Full article
(This article belongs to the Special Issue Advances in Particle Therapy for Cancer Treatment and Research)
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11 pages, 1545 KiB  
Article
Daily Head and Neck Treatment Assessment for Optimal Proton Therapy Planning Robustness
by Leslie Chang, Sherif G. Shaaban, Emile Gogineni, Brandi Page, Harry Quon, Heng Li and Rachel Ger
Cancers 2023, 15(14), 3719; https://doi.org/10.3390/cancers15143719 - 22 Jul 2023
Cited by 3 | Viewed by 1564
Abstract
Robust optimization in proton therapy ensures adequate target coverage; however, validation of fractional plan quality and setup uncertainty in patients has not been performed. We aimed to assess plan robustness on delivered head and neck proton plans classified into two categories: (1) primary [...] Read more.
Robust optimization in proton therapy ensures adequate target coverage; however, validation of fractional plan quality and setup uncertainty in patients has not been performed. We aimed to assess plan robustness on delivered head and neck proton plans classified into two categories: (1) primary only (PO) and (2) primary and neck nodal (PNN) coverage. Registration at the machine was utilized for daily CBCT to generate a synthetic CT. The dose for the clinical target volume (CTV) and organs at risk (OAR) was compared to the expected robustness bands using 3.5% range uncertainty and 3 mm vs. 5 mm setup uncertainty. The fractional deviation was defined as D95% and V100% outside of uncertainty constraints. About 203 daily fractions from 6 patients were included for analysis. The percentage of fractions that exceeded robustness calculations was greater in 3 mm as compared to 5 mm setup uncertainty for both CTV and OAR volumes. PO plans had clinically insignificant average fractional deviation, less than 1%, in delivered D95% and V100%. In comparison, PNN plans had up to 2.2% average fractional deviation in delivered V100% using 3 mm robustness. Given the need to balance dose accuracy with OAR sparing, we recommend the utilization of 3 mm setup uncertainty as an acceptable simulation of the dose delivered. Full article
(This article belongs to the Special Issue Advances in Particle Therapy for Cancer Treatment and Research)
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12 pages, 1057 KiB  
Systematic Review
Brainstem Toxicity Following Proton Beam Radiation Therapy in Pediatric Brain Tumors: A Systematic Review and Meta-Analysis
by Abdulrahim Saleh Alrasheed, Abdulsalam Mohammed Aleid, Reema Ahmed Alharbi, Mostafa Habeeb Alhodibi, Abdulmonem Ali Alhussain, Awn Abdulmohsen Alessa and Sami Fadhel Almalki
Cancers 2024, 16(21), 3655; https://doi.org/10.3390/cancers16213655 - 30 Oct 2024
Cited by 1 | Viewed by 1581
Abstract
Background: Proton beam radiation therapy (PBRT) is an advanced cancer treatment modality that utilizes the distinctive physical properties of protons to precisely deliver radiation to tumor targets while sparing healthy tissue. This cannot be obtained with photon radiation. In this systematic review and [...] Read more.
Background: Proton beam radiation therapy (PBRT) is an advanced cancer treatment modality that utilizes the distinctive physical properties of protons to precisely deliver radiation to tumor targets while sparing healthy tissue. This cannot be obtained with photon radiation. In this systematic review and meta-analysis, we aimed to comprehensively assess the risk of brainstem toxicity in pediatric brain tumor patients undergoing PBRT. Methods: With adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a predetermined search strategy was used to identify eligible articles from PubMed, Web of Science, Scopus, and Cochrane Library through July 2024. Results: The current study included a total of 11 eligible articles. The pooled prevalence of patients who suffered from brainstem toxicity was 1.8% (95% CI: 1%, 2.6%). The pooled prevalences of patients with Grade 1 to Grade 5 brainstem toxicity were found to be 10.6% (95% CI: 8.8%, 30%), 1.5% (95% CI: 0.6%, 2.5%), 0.7% (95% CI: 0.3%, 1.1%), 0.4% (95% CI: 0.1%, 0.7%), and 0.4% (95% CI: 0.1%, 0.8%), respectively, with an overall pooled prevalence of 0.7% (95% CI: 0.4%, 1%). Conclusions: This study revealed a relatively low incidence of symptomatic brainstem toxicity and its related mortality in the pediatric population undergoing PBRT. However, further research is encouraged to study the broader effects of PBRT and to explore various factors that may influence the risk of brainstem toxicity in patients treated with PBRT. Full article
(This article belongs to the Special Issue Advances in Particle Therapy for Cancer Treatment and Research)
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