ArticleJournal of applied clinical medical physics2026
Proton arc therapy reduces the dose delivered to circulating blood compared to intensity-modulated proton therapy for head-and-neck cancer.
Article in Journal of applied clinical medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCompared to intensity-modulated proton therapy (IMPT), proton arc therapy (PAT) has various dosimetric advantages. However, questions have been raised over whether the larger low-dose bath during PAT may increase radiation-induced lymphocyte killing, which is correlated with adverse clinical outcomes. PURPOSE: The purpose of this study is to quantitatively compare radiation dose delivery to circulating blood during IMPT and PAT.
methodsFor each of 10 head-and-neck cancer patients, one IMPT and one PAT treatment plan were created, and the hematological dose (HEDOS) blood dose model was used to simulate radiation dose delivery to circulating blood. HEDOS simulations utilized gantry angle-wise dose distributions (including for PAT) and considered gantry rotation and energy layer switching as well as irradiation times. Blood dose histograms as well as the mean dose to all simulation blood particles (D
resultsFor IMPT, blood dose metrics (in the form of mean over all patients ± one standard deviation) were (0.522 ± 0.204)Gy(RBE) for D
conclusionsCompared to IMPT, proton arc therapy was associated with significantly lower radiation dose delivery to circulating blood across a variety of different metrics. Proton arc therapy for head-and-neck cancer is therefore not expected to result in higher radiation-induced killing of circulating lymphocytes compared to IMPT.
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