The Experts below are selected from a list of 23874 Experts worldwide ranked by ideXlab platform
Alfred R. Smith - One of the best experts on this subject based on the ideXlab platform.
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vision 20 20 Proton Therapy
Medical Physics, 2009Co-Authors: Alfred R. SmithAbstract:The first patients were treated with Proton beams in 1955 at the Lawrence Berkeley Laboratory in California. In 1970, Proton beams began to be used in research facilities to treat cancer patients using fractionated treatment regimens. It was not until 1990 that Proton treatments were carried out in hospital-based facilities using technology and techniques that were comparable to those for modern photon Therapy. Clinical data strongly support the conclusion that Proton Therapy is superior to conventional radiation Therapy in a number of disease sites. Treatment planning studies have shown that Proton dose distributions are superior to those for photons in a wide range of disease sites indicating that additional clinical gains can be achieved if these treatment plans can be reliably delivered to patients. Optimum Proton dose distributions can be achieved with intensity modulated Protons (IMPT), but very few patients have received this advanced form of treatment. It is anticipated widespread implementation of IMPT would provide additional improvements in clinical outcomes. Advances in the last decade have led to an increased interest in Proton Therapy. Currently, Proton Therapy is undergoing transitions that will move it into the mainstream of cancer treatment. For example, Proton Therapy is now reimbursed, there has been rapid development in Proton Therapy technology, and many new options are available for equipment, facility configuration, and financing. During the next decade, new developments will increase the efficiency and accuracy of Proton Therapy and enhance our ability to verify treatment planning calculations and perform quality assurance for Proton Therapy delivery. With the implementation of new multi-institution clinical studies and the routine availability of IMPT, it may be possible, within the next decade, to quantify the clinical gains obtained from optimized Proton Therapy. During this same period several new Proton Therapy facilities will be built and the cost of Proton Therapy is expected to decrease, making Proton Therapy routinely available to a larger population of cancer patients.
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Vision 20/20: Proton Therapy.
Medical physics, 2009Co-Authors: Alfred R. SmithAbstract:The first patients were treated with Proton beams in 1955 at the Lawrence Berkeley Laboratory in California. In 1970, Proton beams began to be used in research facilities to treat cancer patients using fractionated treatment regimens. It was not until 1990 that Proton treatments were carried out in hospital-based facilities using technology and techniques that were comparable to those for modern photon Therapy. Clinical data strongly support the conclusion that Proton Therapy is superior to conventional radiation Therapy in a number of disease sites. Treatment planning studies have shown that Proton dose distributions are superior to those for photons in a wide range of disease sites indicating that additional clinical gains can be achieved if these treatment plans can be reliably delivered to patients. Optimum Proton dose distributions can be achieved with intensity modulated Protons (IMPT), but very few patients have received this advanced form of treatment. It is anticipated widespread implementation of IMPT would provide additional improvements in clinical outcomes. Advances in the last decade have led to an increased interest in Proton Therapy. Currently, Proton Therapy is undergoing transitions that will move it into the mainstream of cancer treatment. For example, Proton Therapy is now reimbursed, there has been rapid development in Proton Therapy technology, and many new options are available for equipment, facility configuration, and financing. During the next decade, new developments will increase the efficiency and accuracy of Proton Therapy and enhance our ability to verify treatment planning calculations and perform quality assurance for Proton Therapy delivery. With the implementation of new multi-institution clinical studies and the routine availability of IMPT, it may be possible, within the next decade, to quantify the clinical gains obtained from optimized Proton Therapy. During this same period several new Proton Therapy facilities will be built and the cost of Proton Therapy is expected to decrease, making Proton Therapy routinely available to a larger population of cancer patients.
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Present Status and Future Developments in Proton Therapy
AIP Conference Proceedings, 2009Co-Authors: Alfred R. SmithAbstract:Within the past few years, interest in Proton Therapy has significantly increased. This interest has been generated by a number of factors including: 1) the reporting of positive clinical results using Proton beams; 2) approval of reimbursement for delivery of Proton Therapy; 3) the success of hospital‐based Proton Therapy centers; and 4) the availability of modern, integrated Proton Therapy technology for hospital‐based facilities. In the United States, this increased interest has occurred particularly at the level of smaller academic hospitals, community medical centers, and large private practices; however, interest from large academic centers continues to be strong. Particular interest exists regarding smaller and less‐expensive Proton Therapy systems, especially the so‐called “single‐room” systems. In this paper, the advantages and disadvantages of 1‐room Proton Therapy systems will be discussed. The emphasis on smaller and cheaper Proton Therapy facilities has also generated interest in new Proton‐accelerating technologies such as superconducting cyclotrons and synchrocyclotrons, laser acceleration, and dielectric‐wall accelerators. Superconducting magnets are also being developed to decrease the size and weight of isocentric gantries. Another important technical development is spot‐beam scanning, which offers the ability to deliver intensity‐modulated Proton treatments (IMPT). IMPT has the potential to provide dose distributions that are superior to those for photon intensity modulation techniques (IMXT) and to improve clinical outcomes for patients undergoing cancer Therapy. At the present time, only two facilities—one in Europe and one in the United States—have the ability to deliver IMPT treatments, however, within the next year or two several additional facilities are expected to achieve this capability.
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MO-B-AUD C-01: Proton Therapy
Medical Physics, 2008Co-Authors: Alfred R. Smith, Harald PaganettiAbstract:The clinical advantages of Protonbeams have become widely recognized and there has recently been a significant increase in interest for building additional Proton Therapy facilities. There are currently over 25 institutions worldwide treating patients with Protonbeams and over 55,000 patients have been treated. There are at least 25 new facilities in various stages of planning and building. However, the fraction of patients treated with Protons each year remains extremely small compared to the total number of cancer patients treated with external beamphotons and electrons. The advantage of Protonbeams lies primarily in their excellent dose localization as compared to that which can be achieved using photonbeams. Due to the Bragg peak characteristic in the depth dose of Protonbeams, the integral dose from Proton Therapy is, in general, about two times less that that for photontreatments. This allows higher doses to be delivered to target volumes, resulting in increased probabilities of local control, and lower doses delivered to critical normal tissues, resulting in decreased probabilities of treatment‐related morbidity. There are many challenges associated with increasing the accessibility of Proton Therapy not the least of which is the very limited number of clinical staff with knowledge of and training in Proton Therapy. The aim of the present Continuing Education Course is to provide a basic understanding of the rationale for Proton Therapy,physics of Protonbeams, technology of Protonbeam acceleration and transport,delivery of Protontreatments,Protontreatment planning and clinical results of Proton Therapy. Educational Objectives: 1. Understanding of the physical characteristics of Protonbeams and interactions in tissues. 2. Understanding of the beam production and treatmentdelivery technology for Protonbeams. 3. Understanding of the clinical commissioning of Proton Therapybeams. 4. Understanding of the basic principles of Protontreatment planning. 5. Understanding of the clinical results for Proton Therapy.
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MO-B-M100F-01: Proton Therapy
Medical Physics, 2007Co-Authors: Alfred R. Smith, Harald PaganettiAbstract:The clinical advantages of Protonbeams have become widely recognized and there has recently been a significant increase in interest for building additional Proton Therapy facilities. There are currently over 25 institutions worldwide treating patients with Protonbeams and over 50,000 patients have been treated. There are at least 25 new facilities in various stages of planning and building. However, the fraction of patients treated with Protons each year remains extremely small compared to the total number of cancer patients treated with external beamphotons and electrons. The advantage of Protonbeams lies primarily in their excellent dose localization as compared to that which can be achieved using photonbeams. Due to the Bragg peak characteristic in the depth dose of Protonbeams, the integral dose from Proton Therapy is significantly less that that for photontreatments. This allows higher doses to be delivered to target volumes, resulting in increased rates of local control, and lower doses delivered to critical normal tissues, resulting in decreased rates of treatment‐related morbidity. There are many challenges associated with increasing the accessibility of Proton Therapy not the least of which is the very limited number of clinical staff with knowledge of and training in Proton Therapy. The aim of the present Continuing Education Course is to provide a basic understanding of the rationale for Proton Therapy,physics of Protonbeams, technology of Protonbeam acceleration and transport,delivery of Protontreatments,Protontreatment planning and clinical results of Proton Therapy. Educational Objectives: Understanding of 1. the physical characteristics of Protonbeams and interactions in tissues. 2. the beam production and treatmentdelivery technology for Protonbeams. 3. the clinical commissioning of Proton Therapybeams. 4. the basic principles of Protontreatment planning. 5. the clinical results for Proton Therapy.
Antony J Lomax - One of the best experts on this subject based on the ideXlab platform.
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Treatment planning optimisation in Proton Therapy.
The British journal of radiology, 2013Co-Authors: S E Mcgowan, Neil G. Burnet, Antony J LomaxAbstract:The goal of radioTherapy is to achieve uniform target coverage while sparing normal tissue. In Proton Therapy, the same sources of geometric uncertainty are present as in conventional radioTherapy. However, an important and fundamental difference in Proton Therapy is that Protons have a finite range, highly dependent on the electron density of the material they are traversing, resulting in a steep dose gradient at the distal edge of the Bragg peak. Therefore, an accurate knowledge of the sources and magnitudes of the uncertainties affecting the Proton range is essential for producing plans which are robust to these uncertainties. This review describes the current knowledge of the geometric uncertainties and discusses their impact on Proton dose plans. The need for patient-specific validation is essential and in cases of complex intensity-modulated Proton Therapy plans the use of a planning target volume (PTV) may fail to ensure coverage of the target. In cases where a PTV cannot be used, other methods of quantifying plan quality have been investigated. A promising option is to incorporate uncertainties directly into the optimisation algorithm. A further development is the inclusion of robustness into a multicriteria optimisation framework, allowing a multi-objective Pareto optimisation function to balance robustness and conformity. The question remains as to whether adaptive Therapy can become an integral part of a Proton Therapy, to allow re-optimisation during the course of a patient's treatment. The challenge of ensuring that plans are robust to range uncertainties in Proton Therapy remains, although these methods can provide practical solutions.
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Emerging technologies in Proton Therapy.
Acta oncologica (Stockholm Sweden), 2011Co-Authors: Jacobus M Schippers, Antony J LomaxAbstract:An increasing number of Proton Therapy facilities are being planned and built at hospital based centers. Most facilities are employing traditional dose delivery methods. A second generation of dose application techniques, based on pencil beam scanning, is slowly being introduced into the commercially available Proton Therapy systems. New developments in accelerator physics are needed to accommodate and fully exploit these new techniques. At the same time new developments such as the development of small cyclotrons, Dielectric Wall Accelerator (DWA) and laser driven systems, aim for smaller, single room treatment units. In general the benefits of Proton Therapy could be exploited optimally when achieving a higher level in accuracy, beam energy, beam intensity, safety and system reliability. In this review an overview of the current developments will be given followed by a discussion of upcoming new technologies and needs, like increase of energy, on-line MRI and Proton beam splitting for independent uses of treatment rooms.
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The clinical potential of intensity modulated Proton Therapy.
Zeitschrift fur medizinische Physik, 2004Co-Authors: Antony J Lomax, Eros Pedroni, Hans Peter Rutz, Gudrun GoiteinAbstract:Abstract Intensity Modulated Proton Therapy (IMPT) differs from conventional Proton Therapy in its ability to deliver depth-shifted, arbitrarily complex Proton fluence maps from each incident field direction. As the individual Bragg peaks delivered from any field can be distributed in three-dimensions throughout the target volume, IMPT provides many more degrees of freedom for designing dose distributions than IMRT or conventional Proton Therapy techniques. So how can the flexibility of IMPT best be exploited? Here we argue that IMPT has two main advantages over photon IMRT and conventional Proton Therapy: the ability to better ‘sculpt’ the dose to the target and around neighbouring critical structures, and the ability to find clinically acceptable solutions whilst simultaneously reducing the sensitivity of the treatments to potential delivery errors. The concept of IMPT as a tool for generating ‘safer’ plans opens an interesting new avenue of research from the point of view of plan optimisation, the potential of which is only just beginning to be explored.
Harald Paganetti - One of the best experts on this subject based on the ideXlab platform.
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Roadmap: Proton Therapy physics and biology
Physics in medicine and biology, 2020Co-Authors: Harald Paganetti, Lei Dong, Chris Beltran, Stefan Both, J Flanz, Keith M. Furutani, Clemens Grassberger, David R. Grosshans, Antje-christin Knopf, Johannes A. LangendijkAbstract:The treatment of cancer with Proton radiation Therapy was first suggested in 1946 followed by the first treatments in the 1950s. As of 2020, almost 200,000 patients have been treated with Proton beams worldwide and the number of operating Proton Therapy facilities will soon reach one hundred. Proton Therapy has long moved from research institutions into hospital-based facilities that are increasingly being utilized with workflows similar to conventional radiation Therapy. While Proton Therapy has become mainstream and has established itself as a treatment option for many cancers, it is still an area of active research for various reasons: the advanced dose shaping capabilities of Proton Therapy cause susceptibility to uncertainties, the high degrees of freedom in dose delivery offer room for further improvements, the limited experience and understanding of optimizing pencil beam scanning, and the biological effects differ from photon radiation. In addition to these challenges and opportunities currently being investigated, there is an economic aspect because Proton Therapy treatments are, on average, still more expensive compared to conventional photon based treatment options. This roadmap highlights the current state and future direction in Proton Therapy categorized into four different themes, "improving efficiency", "improving planning and delivery", "improving imaging", and "improving patient selection".
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Proton Therapy Physics - Proton Therapy Physics.
Medical Physics, 2013Co-Authors: Harald PaganettiAbstract:This article reviews Proton Therapy Physics. by H. Paganetti , Boca Raton, FL, 2012. 704 pp. Price: $129.95. ISBN: 9781439836446 (hardcover).
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Proton Therapy Physics - Proton Therapy physics
Series in Medical Physics and Biomedical Engineering, 2011Co-Authors: Harald PaganettiAbstract:Proton Therapy: History and Rationale, Harald Paganetti Physics of Proton Interactions in Matter, Bernard Gottschalk Proton Accelerators, Marco Schippers Characteristics of Clinical Proton Beams, Hsiao-Ming Lu and Jacob Flanz Beam Delivery Using Passive Scattering, Roelf Slopsema Particle Beam Scanning, Jacob Flanz Dosimetry, Hugo Palmans Quality Assurance and Commissioning, Zuofeng Li, Roelf Slopsema, Stella Flampouri, and Daniel K. Yeung Monte Carlo Simulations, Harald Paganetti Physics of Treatment Planning for Single-Field Uniform Dose, Martijn Engelsman Physics of Treatment Planning Using Scanned Beams, Antony Lomax Dose Calculation Algorithms, Benjamin Clasie, Harald Paganetti, and Hanne M. Kooy Precision and Uncertainties in Proton Therapy for Nonmoving Targets, Jatinder R. Palta and Daniel K. Yeung Precision and Uncertainties in Proton Therapy for Moving Targets, Martijn Engelsman and Christoph Bert Treatment-Planning Optimization, Alexei V. Trofimov, Jan H. Unkelbach, and David Craft In Vivo Dose Verification, Katia Parodi Basic Aspects of Shielding, Nisy Elizabeth Ipe Late Effects from Scattered and Secondary Radiation, Harald Paganetti The Physics of Proton Biology, Harald Paganetti Fully Exploiting the Benefits of Protons: Using Risk Models for Normal Tissue Complications in Treatment Optimization, Peter van Luijk and Marco Schippers Index
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Proton Therapy physics
Medical Physics, 2011Co-Authors: Harald PaganettiAbstract:This article reviews Proton Therapy Physics. by H. Paganetti , Boca Raton, FL, 2012. 704 pp. Price: $129.95. ISBN: 9781439836446 (hardcover).
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MO-B-AUD C-01: Proton Therapy
Medical Physics, 2008Co-Authors: Alfred R. Smith, Harald PaganettiAbstract:The clinical advantages of Protonbeams have become widely recognized and there has recently been a significant increase in interest for building additional Proton Therapy facilities. There are currently over 25 institutions worldwide treating patients with Protonbeams and over 55,000 patients have been treated. There are at least 25 new facilities in various stages of planning and building. However, the fraction of patients treated with Protons each year remains extremely small compared to the total number of cancer patients treated with external beamphotons and electrons. The advantage of Protonbeams lies primarily in their excellent dose localization as compared to that which can be achieved using photonbeams. Due to the Bragg peak characteristic in the depth dose of Protonbeams, the integral dose from Proton Therapy is, in general, about two times less that that for photontreatments. This allows higher doses to be delivered to target volumes, resulting in increased probabilities of local control, and lower doses delivered to critical normal tissues, resulting in decreased probabilities of treatment‐related morbidity. There are many challenges associated with increasing the accessibility of Proton Therapy not the least of which is the very limited number of clinical staff with knowledge of and training in Proton Therapy. The aim of the present Continuing Education Course is to provide a basic understanding of the rationale for Proton Therapy,physics of Protonbeams, technology of Protonbeam acceleration and transport,delivery of Protontreatments,Protontreatment planning and clinical results of Proton Therapy. Educational Objectives: 1. Understanding of the physical characteristics of Protonbeams and interactions in tissues. 2. Understanding of the beam production and treatmentdelivery technology for Protonbeams. 3. Understanding of the clinical commissioning of Proton Therapybeams. 4. Understanding of the basic principles of Protontreatment planning. 5. Understanding of the clinical results for Proton Therapy.
Jon J. Kruse - One of the best experts on this subject based on the ideXlab platform.
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MO‐A‐201‐01: A Cliff's Notes Version of Proton Therapy
Medical Physics, 2016Co-Authors: Jon J. KruseAbstract:Proton Therapy is a rapidly growing modality in the fight against cancer. From a high-level perspective the process of Proton Therapy is identical to x-ray based external beam radioTherapy. However, this course is meant to illustrate for x-ray physicists the many differences between x-ray and Proton based practices. Unlike in x-ray Therapy, Proton dose calculations use CT Hounsfield Units (HU) to determine Proton stopping power and calculate the range of a beam in a patient. Errors in stopping power dominate the dosimetric uncertainty in the beam direction, while variations in patient position determine uncertainties orthogonal to the beam path. Mismatches between geometric and range errors lead to asymmetric uncertainties, and so while geometric uncertainties in x-ray Therapy are mitigated through the use of a Planning Target Volume (PTV), this approach is not suitable for Proton Therapy. Robust treatment planning and evaluation are critical in Proton Therapy, and will be discussed in this course. Predicting the biological effect of a Proton dose distribution within a patient is also a complex undertaking. The Proton Therapy community has generally regarded the Radiobiological Effectiveness (RBE) of a Proton beam to be 1.1 everywhere in the patient, but there are increasing data to suggest that the RBE probably climbs higher than 1.1 near the end of a Proton beam when the energy deposition density increases. This lecture will discuss the evidence for variable RBE in Proton Therapy and describe how this is incorporated into current Proton treatment planning strategies. Finally, there are unique challenges presented by the delivery process of Proton Therapy. Many modern systems use a spot scanning technique which has several advantages over earlier scattered beam designs. However, the time dependence of the dose deposition leads to greater concern with organ motion than with scattered Protons or x-rays. Image guidance techniques in Proton Therapy may also differ from standard x-ray approaches, due to equipment design or the desire to maximize efficiency within a high-cost Proton Therapy treatment room. Differences between x-ray and Proton Therapy delivery will be described. Learning Objectives: 1.Understand how CT HU are calibrated to provide Proton stopping power, and the sources of uncertainty in this process. 2.Understand why a PTV is not suitable for Proton Therapy, and how robust treatment planning and evaluation are used to mitigate uncertainties. 3.Understand the source and implications of variable RBE in Proton Therapy 4.Learn about Proton specific challenges and approaches in beam delivery and image guidance Jon Kruse has a research grant from Varian Medical Systems related to Proton Therapy treatment plannning.; J. Kruse, Jon Kruse has a research grant with Varian Medical Systems related to Proton Therapy planning.
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MO-A-201-00: A Cliff's Notes Version of Proton Therapy
Medical Physics, 2016Co-Authors: Jon J. KruseAbstract:Proton Therapy is a rapidly growing modality in the fight against cancer. From a high-level perspective the process of Proton Therapy is identical to x-ray based external beam radioTherapy. However, this course is meant to illustrate for x-ray physicists the many differences between x-ray and Proton based practices. Unlike in x-ray Therapy, Proton dose calculations use CT Hounsfield Units (HU) to determine Proton stopping power and calculate the range of a beam in a patient. Errors in stopping power dominate the dosimetric uncertainty in the beam direction, while variations in patient position determine uncertainties orthogonal to the beam path. Mismatches between geometric and range errors lead to asymmetric uncertainties, and so while geometric uncertainties in x-ray Therapy are mitigated through the use of a Planning Target Volume (PTV), this approach is not suitable for Proton Therapy. Robust treatment planning and evaluation are critical in Proton Therapy, and will be discussed in this course. Predicting the biological effect of a Proton dose distribution within a patient is also a complex undertaking. The Proton Therapy community has generally regarded the Radiobiological Effectiveness (RBE) of a Proton beam to be 1.1 everywhere in the patient, but there are increasing data to suggest that the RBE probably climbs higher than 1.1 near the end of a Proton beam when the energy deposition density increases. This lecture will discuss the evidence for variable RBE in Proton Therapy and describe how this is incorporated into current Proton treatment planning strategies. Finally, there are unique challenges presented by the delivery process of Proton Therapy. Many modern systems use a spot scanning technique which has several advantages over earlier scattered beam designs. However, the time dependence of the dose deposition leads to greater concern with organ motion than with scattered Protons or x-rays. Image guidance techniques in Proton Therapy may also differ from standard x-ray approaches, due to equipment design or the desire to maximize efficiency within a high-cost Proton Therapy treatment room. Differences between x-ray and Proton Therapy delivery will be described. Learning Objectives: 1.Understand how CT HU are calibrated to provide Proton stopping power, and the sources of uncertainty in this process. 2.Understand why a PTV is not suitable for Proton Therapy, and how robust treatment planning and evaluation are used to mitigate uncertainties. 3.Understand the source and implications of variable RBE in Proton Therapy 4.Learn about Proton specific challenges and approaches in beam delivery and image guidance Jon Kruse has a research grant from Varian Medical Systems related to Proton Therapy treatment plannning.; J. Kruse, Jon Kruse has a research grant with Varian Medical Systems related to Proton Therapy planning.
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MO‐A‐108‐01: The Impact of Intensity Modulated Proton Therapy On Proton Therapy?
Medical Physics, 2013Co-Authors: R. Chen, Thomas Bortfeld, Jon J. Kruse, Xiaodong Zhang, Joe Y. ChangAbstract:One of the major controversies surrounding Proton Therapy is that despite the high cost of Proton Therapy relative to conventional x‐ray radioTherapy, the clinical benefit of Proton Therapy has not been clearly demonstrated in the literature. The majority of clinical studies comparing Proton and photon Therapy have compared passive scattering Proton Therapy (PSPT) with intensity‐modulated radiation Therapy (IMRT). However, the delivery of Proton Therapy, while predominantly in the form of PSPT, is likely to be superseded by intensity modulated Proton Therapy (IMPT). Improvement in dose distribution by IMPT in a representative series of patients compared to IMRT has been reported. It appears that IMPT will have the opportunity to justify adopting the Proton Therapy in the routine care for majority disease.This session will begin with a short introduction explaining the current state of the art for IMPT. This introduction will be followed by four presentations. The first presentation will cover the efficacy of Proton Therapy for prostate cancer from a clinician's point of view. The second presentation will provide more detail on the current state of the art for Proton Therapy, introduce future research directions for IMPT technology, and address the impact of the research on Proton Therapy. The third presentation will cover the clinical and operational reasoning behind an all‐scanning‐beam facility and the expertise needed to build such a facility. In the fourth presentation, a physicist and a physician will present their center's experience with implementing IMPT techniques for lung, head and neck, and central nervous system tumors and present relevant clinical protocols and data. Learning Objectives: 1. Describe the current machine delivery systems and treatment planning, quality assurance, and dose verification techniques for IMPT. 2. Explain the clinical efficacy and cost‐effectiveness of Proton Therapy. 3. Differentiate the capabilities of IMPT from those of PSPT and IMRT and explain how the unique capabilities of IMPT improve the clinical efficacy and cost‐effectiveness of Proton Therapy. 4. Provide examples of working clinical protocols, workflow, and quality assurance procedures for the use of IMPT in routine patient care.
Bradford S. Hoppe - One of the best experts on this subject based on the ideXlab platform.
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Promising long-term results with Proton Therapy for localized prostate cancer.
Nature reviews. Urology, 2021Co-Authors: Curtis Bryant, Bradford S. HoppeAbstract:The value of Proton Therapy in managing prostate cancer is not yet defined. A recent study has reported promising long-term results for patients with localized prostate cancer who received Proton Therapy. However, results from ongoing clinical trials are required before determining the role of Proton Therapy for this indication.
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Proton Therapy for Hodgkin lymphoma
Current Hematologic Malignancy Reports, 2014Co-Authors: Michael S. Rutenberg, Stella Flampouri, Bradford S. HoppeAbstract:Hodgkin lymphoma has gone from an incurable disease to one for which the majority of patients will be cured. Combined chemoTherapy and radioTherapy achieves the best disease control rates and results in many long-term survivors. As a result, a majority of long-term Hodgkin lymphoma survivors live to experience severe late treatment-related complications, especially cardiovascular disease and second malignancies. The focus of research and treatment for Hodgkin lymphoma is to maintain the current high rates of disease control while reducing treatment-related morbidity and mortality. Efforts to reduce late treatment complications focus on improvements in both systemic therapies and radioTherapy. Herein we review the basis for the benefits of Proton Therapy over conventional X-ray Therapy. We review outcomes of Hodgkin lymphoma treated with Proton Therapy, and discuss the ability of Protons to reduce radiation dose to organs at risk and the impact on the most significant late complications related to the treatment.
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Proton Therapy for lung cancer.
Thoracic cancer, 2012Co-Authors: Romaine C. Nichols, Stella Flampouri, Nancy P. Mendenhall, Randal H. Henderson, S Huh, Abubakr A. Bajwa, Harry J. D'agostino, Dat C. Pham, Bradford S. HoppeAbstract:Proton Therapy is an emerging radioTherapy technology with the potential to improve the therapeutic index in the treatment of lung cancer patients. Since charged particles, such as Protons, have a penetration length that can be modified by using different energies, Protons offer the clinician the ability to modulate radiation dose deposition along the beam path. This facilitates an increase of the dose to the tumor target while minimizing the volume of normal tissue irradiation. Such precise delivery is particularly relevant in the setting of lung cancer where the targeted tissues are in close proximity to moderately radiation-sensitive organs like the spinal cord, heart, and esophagus, but are also effectively surrounded by the normal lung, which is extremely sensitive to radiation damage. Proton Therapy has been investigated for the treatment of surgically curable yet medically inoperable patients as well as patients with regionally advanced disease.
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Proton Therapy for prostate cancer.
Oncology (Williston Park N.Y.), 2011Co-Authors: Bradford S. Hoppe, William M. Mendenhall, Randal H. Henderson, Romaine C. Nichols, Nancy P. MendenhallAbstract:This review discusses the rationale, history, and current status of Proton Therapy for prostate cancer—and controversies regarding it.
