TY - JOUR
T1 - Consensus Guidelines for Implementing Pencil-Beam Scanning Proton Therapy for Thoracic Malignancies on Behalf of the PTCOG Thoracic and Lymphoma Subcommittee
AU - Chang, Joe Y.
AU - Zhang, Xiaodong
AU - Knopf, Antje
AU - Li, Heng
AU - Mori, Shinichiro
AU - Dong, Lei
AU - Lu, Hsiao Ming
AU - Liu, Wei
AU - Badiyan, Shahed N.
AU - Both, Stephen
AU - Meijers, Arturs
AU - Lin, Liyong
AU - Flampouri, Stella
AU - Li, Zuofeng
AU - Umegaki, Kikuo
AU - Simone, Charles B.
AU - Zhu, Xiaorong R.
N1 - Publisher Copyright:
© 2017 The Authors
PY - 2017/9/1
Y1 - 2017/9/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ijrobp.2017.05.014
DO - 10.1016/j.ijrobp.2017.05.014
M3 - Review article
C2 - 28816159
AN - SCOPUS:85027685700
SN - 0360-3016
VL - 99
SP - 41
EP - 50
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 1
ER -