Evidence map›Paper›PMID 42184283›Full record

ArticleThe British journal of radiology2026

Proton pencil beam scanning lattice radiotherapy: technical implementation and comparison against photon-based delivery.

Abdul S Khalid, Adam H Aitkenhead, Matthew Lowe, Matthew Clarke, John-William Warmenhoven, Francesca Fiorini, Thomas W S Satherley, Maxwell Robinson, Geoff S Higgins, Kristoffer Petersson

Abstract readComparative Study
In one paragraph

Article in The British journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Abdul S KhalidChristie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester Academic Health Science Centre (MAHSC), Manchester M20 4BX, United Kingdom.
Adam H AitkenheadChristie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester Academic Health Science Centre (MAHSC), Manchester M20 4BX, United Kingdom.ORCID 0000-0002-3478-5761
Matthew LoweChristie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester Academic Health Science Centre (MAHSC), Manchester M20 4BX, United Kingdom.ORCID 0000-0002-7685-8156
Matthew ClarkeChristie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester Academic Health Science Centre (MAHSC), Manchester M20 4BX, United Kingdom.
John-William WarmenhovenChristie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester Academic Health Science Centre (MAHSC), Manchester M20 4BX, United Kingdom.ORCID 0000-0002-3638-7759
Francesca FioriniDepartment of Radiotherapy Physics, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford OX3 7LE, United Kingdom.ORCID 0000-0001-9783-2062
Thomas W S SatherleyDepartment of Radiotherapy Physics, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford OX3 7LE, United Kingdom.ORCID 0009-0007-6981-4335
Maxwell RobinsonDepartment of Radiotherapy Physics, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford OX3 7LE, United Kingdom.
Geoff S HigginsDepartment of Oncology, University of Oxford, Oxford OX3 7DQ, United Kingdom.ORCID 0000-0003-3072-909X
Kristoffer PeterssonDepartment of Oncology, University of Oxford, Oxford OX3 7DQ, United Kingdom.ORCID 0000-0003-0300-5790

Funding

Cancer Research UK RRNPSF-Jul23/100005Manchester Biomedical Research Center NIHR203308National Institute for Health and Care Research
6 · The paper itself

Abstract

objectivesSpatially fractionated radiotherapy in the form of a lattice of high-dose regions within the tumor has potential to improve the therapeutic response compared to standard radiotherapy. We aimed (1) to develop and dosimetrically validate a proton pencil-beam scanning lattice radiotherapy (LRT) planning technique, (2) to compare against a photon VMAT LRT technique, and (3) to assess which clinical sites are feasible for treatment.

methods10 cases were selected, covering sites in the brain, neck, pelvis, abdomen and shoulder with gross tumor volumes greater than 100 cm3. LRT plans were developed for a Varian ProBeam system, aiming to deliver 20 Gy to the lattice vertices while minimizing dose to surrounding tissues. Plan-specific quality assurance (PSQA) was performed by independent Monte-Carlo calculation and physical dosimetric verification. End-to-end tests were performed using a CIRS head phantom containing EBT4 film. Plan quality was evaluated against VMAT LRT.

resultsClinically acceptable proton LRT plans were produced, delivering 16-20 Gy to the lattice vertices, a mean PTV dose of 2 Gy and satisfying organ-at-risk dose constraints. PSQA and end-to-end tests met clinical tolerances for non-LRT plans. For large target volumes, proton LRT produced lattices with a greater number of vertices than VMAT LRT.

conclusionsProton LRT is technically viable using currently available delivery systems. Large tumors such as sarcoma are the most likely candidates for future clinical studies, but proton LRT is feasible for target volumes as small as 100 cm3. ADVANCES IN KNOWLEDGE: The study demonstrates the feasibility of proton LRT for early phase clinical trials.

Indexed as

NeoplasmsPhotonsProton TherapyRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-AssistedHumansMonte Carlo MethodOrgans at RiskPhantoms, ImagingRadiotherapy Dosagelattice radiotherapyproton therapySFRTVMAT

Identifiers

PMID42184283
PMCPMC13489390

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.