RT Journal Article
T1 Biological and Mechanical Synergies to Deal With Proton Therapy Pitfalls: Minibeams, FLASH, Arcs, andGantryless Rooms
A1 Mazal, Alejandro
A1 Vera Sánchez, Juan Antonio
A1 Sánchez Parcerisa, Daniel
A1 Udías Moinelo, José Manuel
A1 España, Samuel
A1 Sánchez-Tembleque Verbo, Victor
A1 Fraile, Luis Mario
A1 Bragado, Paloma
A1 Gutierrez Uzquiza, Álvaro
A1 Gordillo, Nuria
A1 García, Gastón
A1 Castro Novais, Juan
A1 Pérez Moreno, Juan María
A1 Mayorga Ortiz, Lina
A1 Ilundáin Idoate, Amaia
A1 Cremades Sendino, Marta
A1 Ares, Carme
A1 Miralbell, Raymond
A1 Schreuder, Niek
AB Proton therapy has advantages and pitfalls comparing with photon therapy in radiation therapy. Among the limitations of protons in clinical practice we can selectively mention: uncertainties in range, lateral penumbra, deposition of higher LET outside the target, entrance dose, dose in the beam path, dose constraints in critical organs close to the target volume, organ movements and cost. In this review, we combine proposals under study to mitigate those pitfalls by using individually or in combination: (a) biological approaches of beam management in time (very high dose rate “FLASH” irradiations in the order of 100 Gy/s) and (b) modulation in space (a combination of mini-beams of millimetric extent), together with mechanical approaches such as (c) rotational techniques (optimized in partial arcs) and, in an effort to reduce cost, (d) gantry-less delivery systems.In some cases, these proposals are synergic (e.g., FLASH and minibeams), in others theyare hardly compatible (mini-beam and rotation). Fixed lines have been used in pioneer centers, or for specific indications (ophthalmic, radiosurgery,…), they logically evolved to isocentric gantries. The present proposals to produce fixed lines are somewhat controversial. Rotational techniques, minibeams and FLASH in proton therapy are making their way, with an increasing degree of complexity in these three approaches, but with a high interest in the basic science and clinical communities. All of them must be proven in clinical applications.
SN 2234-943X
YR 2021
FD 2021-01-21
LK https://hdl.handle.net/20.500.14352/7729
UL https://hdl.handle.net/20.500.14352/7729
LA eng
NO This work was partially funded by Comunidad de Madrid (Project B2017/BMD-3888 PRONTO-CM “Proton therapy and nuclear techniques for oncology” and project 2017-T1/BMD5468), Spanish Government (RTI2018-098868-B-I00, RTC2015-3772-1, PID2019-104991RB-I00), European Regional Funds, EU Marie Sklodowska-Curie program (grant agreement 793576-CAPPERAM) is acknowledged.
NO Unión Europea. Horizonte 2020
NO Ministerio de Ciencia e Innovación (MICINN)
NO Comunidad de Madrid
NO Campus de Excelencia Internacional Moncloa
DS Docta Complutense
RD 28 abr 2024