A retrospective bilateral breast proton pencil beam scanning and photon volumetric arc therapy planning comparison.

Background: Advanced bilateral breast cancers with local and regional nodal involvement are rare and challenging to plan due to conflicting demands of conformality, uniformity and sparing of organs at risk such as heart and lungs. Pencil beam scanning (PBS) protons have been shown to provide improved organ at risk (OAR) sparing, conformality and homogeneity compared to photon techniques including three-dimensional conformal radiotherapy, intensity modulated radiation therapy (IMRT), volumetric arc therapy (VMAT), and tomotherapy. We performed a blinded comparison between VMAT and PBS plans and extend this comparison with a case study of a patient win expander during radiotherapy.

Proton reirradiation for recurrent or new primary breast cancer in the setting of prior breast irradiation.

Background And Purpose: Late local recurrences and second primary breast cancers are increasingly common. Proton beam therapy (PBT) reirradiation (reRT) may allow safer delivery of a second definitive radiotherapy (RT) course. We analyzed outcomes of patients with recurrent or new primary breast cancer who underwent reRT.

Dosimetric evaluation of MR-derived synthetic-CTs for MR-only proton treatment planning.

Purpose: To evaluate proton dose calculation accuracy of optimized pencil beam scanning (PBS) plans on MR-derived synthetic-CTs for prostate patients.

Material And Methods: Ten patient datasets with both a CT and an MRI were planned with opposed lateral proton beams optimized to single field uniform dose under an IRB-approved study. The proton plans were created on CT datasets generated by a commercial synthetic CT-based software called MRCAT (MR for Calculating ATtenuation) routinely used in our clinic for photon-based MR-only planning.