Recommendations for reporting and evaluating proton therapy beyond dose and constant relative biological effectiveness.

Background And Purpose: In proton therapy, a relative biological effectiveness (RBE) of 1.1 is used to convert proton dose into an equivalent photon dose. However, RBE varies with tissue type, fraction dose, and beam quality parameters beyond dose such as linear energy transfer (LET) raising concerns about increased local effectiveness and potential toxicity.

Individualized evaluation of the total dose received by radiotherapy patients: Integrating in-field, out-of-field, and imaging doses.

Purpose: To propose a methodology for integrating the out-of-field and imaging doses to the in-field dose received by radiotherapy (RT) patients. In addition, the impact of considering the total dose in planning and radiation-induced second malignancies (RISM) risk assessment will be evaluated in several scenarios comprising photon and proton treatments.

Methods: The total dose is the voxel-wise sum of the doses from the different radiation sources (accounting for the radiobiological effectiveness) produced during the whole RT chain.

Dosimetric evaluation of intensity modulated photon versus proton reirradiation of head and neck cancer.

Background: Reirradiation of head and neck cancer (HNC) became more accessible in the last decade, owing to modern irradiation techniques which offer a reduction in treatment related toxicities. The aim of this paper was to comparatively evaluate the dosimetric aspects derived from intensity modulated photon vs. proton treatment planning in reirradiated HNC patients.

Impact of setup and geometric uncertainties on the robustness of free-breathing photon radiotherapy of small lung tumors.

Purpose: Respiratory motion and patient setup error both contribute to the dosimetric uncertainty in radiotherapy of lung tumors. Managing these uncertainties for free-breathing treatments is usually done by margin-based approaches or robust optimization. However, breathing motion can be irregular and concerns have been raised for the robustness of the treatment plans.

Patterns of practice of image guided particle therapy for cranio-spinal irradiation: A site specific multi-institutional survey of European Particle Therapy Network.

Purpose: To investigate the current practice patterns in image-guided particle therapy (IGPT) for cranio-spinal irradiation (CSI).

Methods: A multi-institutional survey was distributed to European particle therapy centres to analyse all aspects of IGPT. Based on the survey results, a Delphi consensus analysis was developed to define minimum requirements and optimal workflow for clinical practice.