NRG Oncology and Particle Therapy Co-Operative Group Patterns of Practice Survey and Consensus Recommendations on Pencil-Beam Scanning Proton Stereotactic Body Radiation Therapy and Hypofractionated Radiation Therapy for Thoracic Malignancies

Authors

Wei Liu
Hongying Feng
Paige A Taylor
Minglei Kang
Jiajian Shen
Jatinder Saini
Jun Zhou
Huan B Giap
Nathan Y Yu
Terence S Sio
Pranshu Mohindra
Joe Y Chang
Jeffrey D Bradley
Ying Xiao
Charles B Simone
Liyong Lin

Publication Date

7-15-2024

Journal

International Journal of Radiation Oncology, Biology, Physics

Abstract

Stereotactic body radiation therapy (SBRT) and hypofractionation using pencil-beam scanning (PBS) proton therapy (PBSPT) is an attractive option for thoracic malignancies. Combining the advantages of target coverage conformity and critical organ sparing from both PBSPT and SBRT, this new delivery technique has great potential to improve the therapeutic ratio, particularly for tumors near critical organs. Safe and effective implementation of PBSPT SBRT/hypofractionation to treat thoracic malignancies is more challenging than the conventionally fractionated PBSPT because of concerns of amplified uncertainties at the larger dose per fraction. The NRG Oncology and Particle Therapy Cooperative Group Thoracic Subcommittee surveyed proton centers in the United States to identify practice patterns of thoracic PBSPT SBRT/hypofractionation. From these patterns, we present recommendations for future technical development of proton SBRT/hypofractionation for thoracic treatment. Among other points, the recommendations highlight the need for volumetric image guidance and multiple computed tomography-based robust optimization and robustness tools to minimize further the effect of uncertainties associated with respiratory motion. Advances in direct motion analysis techniques are urgently needed to supplement current motion management techniques.

Keywords

Proton Therapy, Humans, Radiosurgery, Radiation Dose Hypofractionation, Thoracic Neoplasms, Consensus, Organs at Risk, Radiation Oncology, Practice Patterns, Physicians', Radiotherapy Planning, Computer-Assisted, Radiotherapy, Image-Guided, United States, Tomography, X-Ray Computed, Lung Neoplasms

DOI

10.1016/j.ijrobp.2024.01.216

PMID

38395086

PMCID

PMC11209785

PubMedCentral® Posted Date

7-15-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes