ArticleRadiation oncology (London, England)2020
Improve the dosimetric outcome in bilateral head and neck cancer (HNC) treatment using spot-scanning proton arc (SPArc) therapy: a feasibility study.
Article in Radiation oncology (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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28 citing papers in PubMed, 65 citations in OpenAlex.
- Machine Model-Specific Delivery Sequence Optimization for Spot-scanning Proton Arc Therapy Using a Compact Superconducting Synchrocyclotron.Medical physics · 2026Article
- Develop a novel non-coplanar trajectory optimization algorithm for an efficient 4pi spot-scanning proton Arc (SPArcMedical physics · 2026Article
- Particle Arc Therapy in Cancer Radiotherapy: A Scoping Review of Feasibility and Dosimetric Evidence.Cancers · 2026Review
- Advancing proton therapy: Dosimetric superiority of proton arc therapy over IMPT in esophageal cancer treatment.Journal of applied clinical medical physics · 2026Article
- Treatment planning comparison of proton arc therapy and intensity modulated proton therapy for synchronous bilateral breast or chest wall and regional nodal irradiation.Physics and imaging in radiation oncology · 2026Article
- Upright positioning enhances beam angle optimization and organ sparing in head and neck carbon-ion radiotherapy with fixed-beam systems.Radiation oncology (London, England) · 2025Article
- Automated Planning for Bias-Free Validation of Discrete Proton Arc Therapy for Oropharyngeal Cancer.International journal of particle therapy · 2025Article
- A novel adaptive energy switching algorithm for proton arc therapy based on the machine-specific delivery characteristics.Medical physics · 2025Article
- Shoot-through layers in upright proton arcs unlock advantages in plan quality and range verification.Medical physics · 2025Article
- Exploring the potential benefits of multi-field IMPT for stage I NSCLC SBRT: An in silico dosimetric comparison to IMRT and CyberKnife.Precision radiation oncology · 2025Article
- Early generation dynamic and static proton arc treatment planning algorithms assessment in oropharyngeal cancer patients.Medical physics · 2025Article
- Feasibility of Utilizing Spot-Scanning Proton Arc (SPArc) for Whole-Lung Irradiation: A Case Report.International journal of particle therapy · 2025Article
- First Clinical Implementation of Step-and-Shoot Proton Arc Therapy for Head and Neck Cancer Treatment.International journal of particle therapy · 2025Article
- Dosimetric comparison of intensity-modulated proton therapy and proton arc therapy for pediatric ependymoma.Acta oncologica (Stockholm, Sweden) · 2025Article
- Partial and full arc with DynamicARC technique in pencil beam scanning proton therapy for bilateral head and neck cancer: A feasibility and dosimetric study.Journal of applied clinical medical physics · 2025Article
- Towards faster plan adaptation for proton arc therapy using initial treatment plan information.Physics and imaging in radiation oncology · 2025Article
- Explore the feasibility of using spot-scanning proton arc therapy for a synchrotron accelerator-based proton therapy system - A simulation study.Journal of applied clinical medical physics · 2025Article
- Rotationally Intensified Proton Lattice: A Novel Lattice Technique Using Spot-Scanning Proton Arc Therapy.Advances in radiation oncology · 2024Article
- A dosimetric and robustness analysis of proton arc therapy with early energy layer and spot assignment for lung cancer versus conventional intensity modulated proton therapy.Acta oncologica (Stockholm, Sweden) · 2024Article
- Emulating the Delivery of Sawtooth Proton Arc Therapy Plans on a Cyclotron-Based Proton Beam Therapy System.Cancers · 2024Article
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9 authors at 2 institutions in 2 countries.
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Abstract
backgroundTo explore the dosimetric improvement, delivery efficiency, and plan robustness for bilateral head and neck cancer (HNC) treatment utilizing a novel proton therapy technique - the spot-scanning proton arc (SPArc) therapy.
methodsWe evaluated fourteen bilateral HNC patients retrospectively. Both SPArc and 3-field Intensity Modulated Proton Therapy (IMPT) plans were generated for each patient using the same robust optimization parameters. The prescription doses were 70Gy (relative biological effectiveness (RBE) for CTV_high and 60Gy[RBE] for CTV_low. Clinically significant dosimetric parameters were extracted and compared. Root-mean-square deviation dose (RMSDs) Volume Histogram(RVH) was used to evaluate the plan robustness. Total treatment delivery time was estimated based on the machine parameters.
resultsThe SPArc plan was able to provide equivalent or better robust target coverage while showed significant dosimetric improvements over IMPT in most of the organs at risk (OARs). More specifically, it reduced the mean dose of the ipsilateral parotid, contralateral parotid, and oral cavity by 25.8%(p = 0.001), 20.8%(p = 0.001) and 20.3%(p = 0.001) respectively compared to IMPT. This technique reduced D1 (the maximum dose covering 1% volume of a structure) of cord and brain stem by 20.8% (p = 0.009) and 10.7% (p = 0.048), respectively. SPArc also reduced the average integral dose by 17.2%(p = 0.001) and external V3Gy (the volume received 3Gy[RBE]) by 8.3%(p = 0.008) as well. RVH analysis showed that the SPArc plans reduced the dose uncertainties in most OARs compared to IMPT, such as cord: 1.1 ± 0.4Gy[RBE] vs 0.7 ± 0.3Gy[RBE](p = 0.001), brain stem: 0.9 ± 0.7Gy[RBE] vs 0.7 ± 0.7Gy[RBE](p = 0.019), contralateral parotid: 2.5 ± 0.5Gy[RBE] vs 2.2 ± 0.6Gy[RBE](p = 0.022) and ipsilateral parotid: 3.1 ± 0.7Gy[RBE] vs 2.8 ± 0.6Gy[RBE](p = 0.004) respectively. The average total estimated treatment delivery time were 283.4 ± 56.2 s, 469.2 ± 62.0 s and 1294.9 ± 106.7 s based on energy-layer-switching-time (ELST) of 0.1 s, 1 s, and 5 s respectively for SPArc plans, compared to the respective values of 328.0 ± 47.6 s(p = 0.002), 434.1 ± 52.0 s(p = 0.002), and 901.7 ± 74.8 s(p = 0.001) for 3-field IMPT plans. The potential clinical benefit of utilizing SPArc will lead to a decrease in the mean probability of salivary flow dysfunction by 31.3%(p = 0.001) compared with IMPT.
conclusionsSPArc could significantly spare OARs while providing a similar or better robust target coverage compared with IMPT in the treatment of bilateral HNC. In the modern proton system with ELST less than 0.5 s, SPArc could potentially be implemented in the routine clinic with a practical, achievable treatment delivery efficiency.
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