Evaluating and reporting LET and RBE-weighted dose in proton therapy for glioma - The Dutch approach.

Background And Purpose: With proton therapy, the relative biological effectiveness (RBE) accounts for increased DNA damage caused by higher linear energy transfer (LET) compared to photons. However, the LET and hence the RBE varies along the proton range, particularly at the Bragg peak, introducing challenges in proton treatment planning for brain tumors. The aim of this paper is to standardize evaluating and reporting LET and RBE in proton therapy for patients with grade 2 and 3 IDH mutant gliomas among the Dutch proton therapy centers.

Development of patient-specific pre-treatment verification procedure for FLASH proton therapy based on time resolved film dosimetry.

Background: Pre-clinical studies demonstrate that delivering a high dose at a high dose rate result in less toxicity while maintaining tumor control, known as the FLASH effect. In proton therapy, clinical trials have started using 250 MeV transmission beams and more trials are foreseen. A novel aspect of FLASH treatments, compared to conventional radiotherapy, is the importance of dose rate next to dose and geometry.

Dosimetric advantages of adaptive IMPT vs. Enhanced workload and treatment time - A need for automation.

Introduction: In head-and-neck IMPT, trigger-based offline plan adaptation (Offline) is often used. Our goal was to compare this to four alternative adaptive strategies for dosimetry, workload and treatment time, considering also foreseen further technological advancements, including anticipated automation.

Materials And Methods: Alternative strategies included weekly offline re-planning (Offline), daily plan selection from a library (Library and Library) and a fast, approximate daily online re-optimization approach (Online).

Robust IMPT and follow-up toxicity in skull base chordoma and chondrosarcoma-a single-institution clinical experience.

Background: Chordomas and chondrosarcomas of the skull base are rare, slowly growing malignant bone neoplasms. Despite their radioresistant properties, proton therapy has been successfully used as an adjunct to resection or as a definitive treatment. Herewith, we present our experience with robustly optimized intensity-modulated proton therapy (IMPT) and related toxicities in skull base chordoma and chondrosarcoma patients treated at HollandPTC, Delft, the Netherlands.

Explainable Machine Learning Based Prediction of Severity of Heart Failure Using Primary Electronic Health Records.

Heart Failure (HF) is a life-threatening condition. It affects more than 64 million people worldwide. Early diagnosis of HF is extremely crucial.