ArticleJournal of applied clinical medical physics2016
Spot scanning proton therapy minimizes neutron dose in the setting of radiation therapy administered during pregnancy.
Article in Journal of applied clinical medical physics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Pregnancy, cancer, and radiation-a modern refresher.JNCI cancer spectrum · 2026Guideline
- Out-of-field dose assessment for pencil beam scanning proton radiotherapy versus photon radiotherapy for breast cancer in pregnant women.Physics and imaging in radiation oncology · 2025Article
- Treatment of a Pregnant Patient With a Brain Tumor Using Pencil Beam Scanning Proton Therapy.Advances in radiation oncology · 2025Article
- Fetal dose assessment in a pregnant patient with brain tumor: A comparative study of proton PBS and 3DCRT/VMAT radiation therapy techniques.Journal of applied clinical medical physics · 2024Article
- Challenges and opportunities for proton therapy during pregnancy.Acta obstetricia et gynecologica Scandinavica · 2024Article
- A script-enabled interactive checklist document for efficient management of electronic devices in a busy multimodality radiotherapy clinic.Journal of applied clinical medical physics · 2024Article
- Measurements of fetal dose with Mevion S250i proton therapy system with HYPERSCAN.Journal of applied clinical medical physics · 2023Article
- Cancer in pregnancy: treatment effects.Abdominal radiology (New York) · 2023Review
- Risk of cardiac implantable device malfunction in cancer patients receiving proton therapy: an overview.Frontiers in oncology · 2023Review
- Proton therapy of a pregnant patient with nasopharyngeal carcinoma.Clinical and translational radiation oncology · 2022Article
- Fetal dose from proton pencil beam scanning craniospinal irradiation during pregnancy: a Monte Carlo study.Physics in medicine and biology · 2022Article
- Proton Therapy for Intracranial Meningioma for the Treatment of Primary/Recurrent Disease Including Re-Irradiation.Frontiers in oncology · 2020Review
- The Importance of Verification CT-QA Scans in Patients Treated with IMPT for Head and Neck Cancers.International journal of particle therapy · 2020Article
- Active-Scanned Protons and Carbon Ions in Cancer Treatment of Patients With Cardiac Implantable Electronic Devices: Experience of a Single Institution.Frontiers in oncology · 2019Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This is a real case study to minimize the neutron dose equivalent (H) to a fetus using spot scanning proton beams with favorable beam energies and angles. Minimum neutron dose exposure to the fetus was achieved with iterative planning under the guidance of neutron H measurement. Two highly conformal treatment plans, each with three spot scanning beams, were planned to treat a 25-year-old pregnant female with aggressive recurrent chordoma of the base of skull who elected not to proceed with termination. Each plan was scheduled for delivery every other day for robust target coverage. Neutron H to the fetus was measured using a REM500 neutron survey meter placed at the fetus position of a patient simulating phantom. 4.1 and 44.1 μSv/fraction were measured for the two initial plans. A vertex beam with higher energy and the fetal position closer to its central axis was the cause for the plan that produced an order higher neutron H. Replacing the vertex beam with a lateral beam reduced neutron H to be comparable with the other plan. For a prescription of 70 Gy in 35 fractions, the total neutron H to the fetus was estimated to be 0.35 mSv based on final measurement in single fraction. In comparison, the passive scattering proton plan and photon plan had an estimation of 26 and 70 mSv, respectively, for this case. While radiation therapy in pregnant patients should be avoided if at all possible, our work demonstrated spot scanning beam limited the total neutron H to the fetus an order lower than the suggested 5 mSv regulation threshold. It is far superior than passive scattering beam and careful beam selection with lower energy and keeping fetus further away from beam axis are essential in minimizing the fetus neutron exposure.
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