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Article ; Online: To FLASH or to Fractionate? That is the question.

Lomax, Tony / Psoroulas, Serena

2022 Volume 32, Issue 4, Page(s) 387–390

MeSH term(s)	Photic Stimulation ; Time Factors
Language	English
Publishing date	2022-10-31
Publishing country	Germany
Document type	Editorial
ZDB-ID	1104517-6
ISSN	1876-4436 ; 0939-3889 ; 0040-5973
ISSN (online)	1876-4436
ISSN	0939-3889 ; 0040-5973
DOI	10.1016/j.zemedi.2022.10.007
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Article ; Online: Combining rescanning and gating for a time-efficient treatment of mobile tumors using pencil beam scanning proton therapy.

Gut, Pauline / Krieger, Miriam / Lomax, Tony / Weber, Damien C / Hrbacek, Jan

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2021 Volume 160, Page(s) 82–89

Abstract: Background and purpose: Respiratory motion during proton therapy can severely degrade dose distributions, particularly due to interplay effects when using pencil beam scanning. Combined rescanning and gating treatments for moving tumors mitigates dose ... ...

Abstract	Background and purpose: Respiratory motion during proton therapy can severely degrade dose distributions, particularly due to interplay effects when using pencil beam scanning. Combined rescanning and gating treatments for moving tumors mitigates dose degradation, but at the cost of increased treatment delivery time. The objective of this study was to identify the time efficiency of these dose degradation-motion mitigation strategies for different range of motions. Materials and methods: Seventeen patients with thoracic or abdominal tumors were studied. Tumor motion amplitudes ranged from 2-30 mm. Deliveries using different combinations of rescanning and gating were simulated with a dense dose spot grid (4 × 4 × 2.5 mm Results: Based on the studied patient cohort, it has been shown that for amplitudes up to 5 mm, no motion mitigation is required with a dense spot grid. For amplitudes between 5 and 10 mm, volumetric rescanning should be applied while maintaining a 100% duty cycle when using a dense spot grid. Although gating could be envisaged to reduce the target volume for intermediate motion, it has been shown that the dose to normal tissues would only be reduced marginally. Moreover, the treatment time would increase. Finally, for larger motion amplitudes, both volumetric rescanning and respiratory gating should be applied with both spot grids. In addition, it has been shown that a dense spot grid delivers better CTV dose coverage than a sparse dose grid. Conclusion: Volumetric rescanning and/or respiratory gating can be used in order to effectively and efficiently mitigate dose degradation due to tumor movement.
Language	English
Publishing date	2021-04-09
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2021.03.041
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Article ; Online: Neutrons in active proton therapy: Parameterization of dose and dose equivalent.

Schneider, Uwe / Hälg, Roger A / Lomax, Tony

Zeitschrift fur medizinische Physik

2017 Volume 27, Issue 2, Page(s) 113–123

Abstract: Purpose: One of the essential elements of an epidemiological study to decide if proton therapy may be associated with increased or decreased subsequent malignancies compared to photon therapy is an ability to estimate all doses to non-target tissues, ... ...

Abstract	Purpose: One of the essential elements of an epidemiological study to decide if proton therapy may be associated with increased or decreased subsequent malignancies compared to photon therapy is an ability to estimate all doses to non-target tissues, including neutron dose. This work therefore aims to predict for patients using proton pencil beam scanning the spatially localized neutron doses and dose equivalents. Methods: The proton pencil beam of Gantry 1 at the Paul Scherrer Institute (PSI) was Monte Carlo simulated using GEANT. Based on the simulated neutron dose and neutron spectra an analytical mechanistic dose model was developed. The pencil beam algorithm used for treatment planning at PSI has been extended using the developed model in order to calculate the neutron component of the delivered dose distribution for each treated patient. The neutron dose was estimated for two patient example cases. Results: The analytical neutron dose model represents the three-dimensional Monte Carlo simulated dose distribution up to 85cm from the proton pencil beam with a satisfying precision. The root mean square error between Monte Carlo simulation and model is largest for 138MeV protons and is 19% and 20% for dose and dose equivalent, respectively. The model was successfully integrated into the PSI treatment planning system. In average the neutron dose is increased by 10% or 65% when using 160MeV or 177MeV instead of 138MeV. For the neutron dose equivalent the increase is 8% and 57%. Conclusions: The presented neutron dose calculations allow for estimates of dose that can be used in subsequent epidemiological studies or, should the need arise, to estimate the neutron dose at any point where a subsequent secondary tumour may occur. It was found that the neutron dose to the patient is heavily increased with proton energy.
Language	English
Publishing date	2017-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1104517-6
ISSN	1876-4436 ; 0939-3889 ; 0040-5973
ISSN (online)	1876-4436
ISSN	0939-3889 ; 0040-5973
DOI	10.1016/j.zemedi.2016.07.001
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Article ; Online: Al

Christensen, Jeppe Brage / Togno, Michele / Nesteruk, Konrad Pawel / Psoroulas, Serena / Meer, David / Weber, Damien Charles / Lomax, Tony / Yukihara, Eduardo G / Safai, Sairos

Physics in medicine and biology

2021 Volume 66, Issue 8

Abstract: The response of ... ...

Abstract	The response of Al
MeSH term(s)	Luminescence ; Optically Stimulated Luminescence Dosimetry ; Protons ; Radiation Dosimeters ; Radiometry
Chemical Substances	Protons
Language	English
Publishing date	2021-04-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	208857-5
ISSN	1361-6560 ; 0031-9155
ISSN (online)	1361-6560
ISSN	0031-9155
DOI	10.1088/1361-6560/abe554
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Book: Proton and carbon ion therapy

Ma, Chang-Ming Charlie / Lomax, Tony

(Imaging in medical diagnosis and therapy)

2013

Abstract: Preface: This book aims at providing a comprehensive and practical guide to proton and carbon ion therapy for a broad range of personnel in medical physics and radiation therapy, including medical physicists, radiation oncologists, dosimetrists, ... ...

Author's details	edited by C.-M. Charlie Ma, Tony Lomax
Series title	Imaging in medical diagnosis and therapy
Abstract	"Preface: This book aims at providing a comprehensive and practical guide to proton and carbon ion therapy for a broad range of personnel in medical physics and radiation therapy, including medical physicists, radiation oncologists, dosimetrists, therapists, medical engineers, and trainees in these disciplines. The scope of this book includes physics and radiobiology basics of proton and ion beams, dosimetry methods and radiation measurements, treatment delivery systems, and practical guidance on patient setup, target localization, and treatment planning for clinical proton and carbon ion therapy, as well as detailed reports on the treatment of pediatric cancers, lymphomas, and various other cancers. The aim is to offer a balanced and critical assessment of the state-of-the-art proton and carbon ion therapy along with the discussion of major challenges and future outlook. This book contains 11 chapters. The first chapter provides an overview, and the final chapter describes future challenges. The remaining content is divided into three sections. The first section provides the basic aspects of proton and carbon ion therapy equipment covering accelerators, gantries, and delivery systems. Chapter 2 describes accelerators for proton and carbon ion therapy, including cyclotron, synchrotron, and other acceleration developments (such as dielectric wall accelerator, laser accelerated particle beams, and new concepts, including the cyclinac and compact cyclotron solutions). Chapter 3 describes proton and carbon ion therapy systems, with a focus on their major components, including energy selection systems, beam transport systems, control systems, gantries, and beam delivery systems"--Provided by publisher.
MeSH term(s)	Radiotherapy/methods ; Protons/therapeutic use ; Carbon Isotopes/therapeutic use ; Radiometry/methods ; Radiotherapy Dosage
Language	English
Size	xvi, 224 p. :, ill.
Publisher	Taylor & Francis
Publishing place	Boca Raton
Document type	Book
ISBN	9781439816073 ; 1439816077
Database	Catalogue of the US National Library of Medicine (NLM)

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Book: Proton and carbon ion therapy

Lomax, Tony / Ma, Chang-Ming Charlie

(Imaging in medical diagnosis and therapy)

2013

Author's details	ed. by C-M Charlie Ma, Tony Lomax
Series title	Imaging in medical diagnosis and therapy
Abstract	"Preface: This book aims at providing a comprehensive and practical guide to proton and carbon ion therapy for a broad range of personnel in medical physics and radiation therapy, including medical physicists, radiation oncologists, dosimetrists, therapists, medical engineers, and trainees in these disciplines. The scope of this book includes physics and radiobiology basics of proton and ion beams, dosimetry methods and radiation measurements, treatment delivery systems, and practical guidance on patient setup, target localization, and treatment planning for clinical proton and carbon ion therapy, as well as detailed reports on the treatment of pediatric cancers, lymphomas, and various other cancers. The aim is to offer a balanced and critical assessment of the state-of-the-art proton and carbon ion therapy along with the discussion of major challenges and future outlook. This book contains 11 chapters. The first chapter provides an overview, and the final chapter describes future challenges. The remaining content is divided into three sections. The first section provides the basic aspects of proton and carbon ion therapy equipment covering accelerators, gantries, and delivery systems. Chapter 2 describes accelerators for proton and carbon ion therapy, including cyclotron, synchrotron, and other acceleration developments (such as dielectric wall accelerator, laser accelerated particle beams, and new concepts, including the cyclinac and compact cyclotron solutions). Chapter 3 describes proton and carbon ion therapy systems, with a focus on their major components, including energy selection systems, beam transport systems, control systems, gantries, and beam delivery systems"--Provided by publisher
MeSH term(s)	Carbon Isotopes/therapeutic use ; Protons/therapeutic use ; Radiometry/methods ; Radiotherapy/methods ; Radiotherapy Dosage
Language	English
Size	XVI, 224 S., [8] Bl., Ill., 29 cm
Publisher	Taylor & Francis
Publishing place	Boca Raton
Document type	Book
Note	Includes bibliographical references and index
ISBN	9781439816073 ; 1439816077
Database	Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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Article ; Online: Author Correction: Effects of deep inspiration breath hold on prone photon or proton irradiation of breast and regional lymph nodes.

Speleers, Bruno / Schoepen, Max / Belosi, Francesca / Vakaet, Vincent / De Neve, Wilfried / Deseyne, Pieter / Paelinck, Leen / Vercauteren, Tom / Parkes, Michael J / Lomax, Tony / Van Greveling, Annick / Bolsi, Alessandra / Weber, Damien C / Veldeman, Liv / De Gersem, Werner

Scientific reports

2023 Volume 13, Issue 1, Page(s) 13749

Language	English
Publishing date	2023-08-23
Publishing country	England
Document type	Published Erratum
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-40643-2
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Article ; Online: Prognostic impact of the "Sekhar grading system for cranial Chordomas" in patients treated with pencil beam scanning proton therapy: an institutional analysis.

Hottinger, Anna-Lena / Bojaxhiu, Beat / Ahlhelm, Frank / Walser, Marc / Bachtiary, Barbara / Zepter, Stefan / Lomax, Tony / Pica, Alessia / Weber, Damien C

Radiation oncology (London, England)

2020 Volume 15, Issue 1, Page(s) 96

Abstract: Background: Skull base chordomas are rare and heterogeneously behaving tumors. Though still classified as benign they can grow rapidly, are locally aggressive, and have the potential to metastasize. To adapt the treatment to the specific needs of ... ...

Abstract	Background: Skull base chordomas are rare and heterogeneously behaving tumors. Though still classified as benign they can grow rapidly, are locally aggressive, and have the potential to metastasize. To adapt the treatment to the specific needs of patients at higher risk of recurrence, a pre-proton therapy prognostic grading system would be useful. The aim of this retrospective analysis is to assess prognostic factors and the "Sekhar Grading System for Cranial Chordomas" (SGSCC) by evaluating the larger cohort of patients treated at our institution as to determine its reproducibility and ultimately to ensure more risk adapted local treatments for these challenging tumors. Methods: We analyzed 142 patients treated for skull base chordomas between 2004 and 2016. We focused the analysis on the 5 criteria proposed for the SGSCC (tumor size, number of anatomic regions and vessels involved, intradural invasion, as well as recurrence after prior treatment) and classified our patients according to their score (based on the above mentioned criteria) into three prognostic groups, low-risk, intermediate-risk and high-risk. The three groups were then analyzed in regards of local control, local recurrence-free survival and overall survival. Results: The median follow up was 52 months (range, 3-152). We observed 34 (24%) patients with a local recurrence, resulting in a local control of 75% at 5 years. Overall survival was 83% at 5 years, 12 (9%) patients had died due to local progression. When split into the three prognostic groups according to the SGSCC the observed local control was 90, 72 and 64% (p = 0.07) in the low-, intermediate- and high-risk group, respectively. A similar correlation was observed for local recurrence-free survival with 93, 89 and 66% (p = 0.05) and for overall survival with 89, 83 and 76% (p = 0.65) for the same prognostic groups. Conclusions: After splitting our patient cohort into the three SGSCC risk groups, we found a trend towards better outcome for those patients with lower as opposed to higher scores. These results suggest that this prognostic grading system published by Sekhar et al. could be integrated in the management decision-tree for patients with skull base chordoma.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Chordoma/pathology ; Chordoma/radiotherapy ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Middle Aged ; Prognosis ; Proton Therapy ; Retrospective Studies ; Skull Base Neoplasms/pathology ; Skull Base Neoplasms/radiotherapy ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2020-05-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2224965-5
ISSN	1748-717X ; 1748-717X
ISSN (online)	1748-717X
ISSN	1748-717X
DOI	10.1186/s13014-020-01547-x
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Article ; Online: Neutrons in proton pencil beam scanning: parameterization of energy, quality factors and RBE.

Schneider, Uwe / Hälg, Roger A / Baiocco, Giorgio / Lomax, Tony

Physics in medicine and biology

2016 Volume 61, Issue 16, Page(s) 6231–6242

Abstract: The biological effectiveness of neutrons produced during proton therapy in inducing cancer is unknown, but potentially large. In particular, since neutron biological effectiveness is energy dependent, it is necessary to estimate, besides the dose, also ... ...

Abstract	The biological effectiveness of neutrons produced during proton therapy in inducing cancer is unknown, but potentially large. In particular, since neutron biological effectiveness is energy dependent, it is necessary to estimate, besides the dose, also the energy spectra, in order to obtain quantities which could be a measure of the biological effectiveness and test current models and new approaches against epidemiological studies on cancer induction after proton therapy. For patients treated with proton pencil beam scanning, this work aims to predict the spatially localized neutron energies, the effective quality factor, the weighting factor according to ICRP, and two RBE values, the first obtained from the saturation corrected dose mean lineal energy and the second from DSB cluster induction. A proton pencil beam was Monte Carlo simulated using GEANT. Based on the simulated neutron spectra for three different proton beam energies a parameterization of energy, quality factors and RBE was calculated. The pencil beam algorithm used for treatment planning at PSI has been extended using the developed parameterizations in order to calculate the spatially localized neutron energy, quality factors and RBE for each treated patient. The parameterization represents the simple quantification of neutron energy in two energy bins and the quality factors and RBE with a satisfying precision up to 85 cm away from the proton pencil beam when compared to the results based on 3D Monte Carlo simulations. The root mean square error of the energy estimate between Monte Carlo simulation based results and the parameterization is 3.9%. For the quality factors and RBE estimates it is smaller than 0.9%. The model was successfully integrated into the PSI treatment planning system. It was found that the parameterizations for neutron energy, quality factors and RBE were independent of proton energy in the investigated energy range of interest for proton therapy. The pencil beam algorithm has been extended using the developed parameterizations in order to calculate the neutron energy, quality factor and RBE.
MeSH term(s)	Algorithms ; Humans ; Models, Theoretical ; Monte Carlo Method ; Neutrons ; Protons ; Radiometry/instrumentation ; Radiometry/methods ; Relative Biological Effectiveness
Chemical Substances	Protons
Language	English
Publishing date	2016-08-21
Publishing country	England
Document type	Journal Article
ZDB-ID	208857-5
ISSN	1361-6560 ; 0031-9155
ISSN (online)	1361-6560
ISSN	0031-9155
DOI	10.1088/0031-9155/61/16/6231
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Article ; Online: Comparing radiolytic production of H

Kacem, Houda / Psoroulas, Serena / Boivin, Gael / Folkerts, Michael / Grilj, Veljko / Lomax, Tony / Martinotti, Adrien / Meer, David / Ollivier, Jonathan / Petit, Benoit / Safai, Sairos / Sharma, Ricky A / Togno, Michele / Vilalta, Marta / Weber, Damien C / Vozenin, Marie-Catherine

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2022 Volume 175, Page(s) 197–202

Abstract: The physico-chemical and biological response to conventional and UHDR electron and proton beams was investigated, along with conventional photons. The temporal structure and nature of the beam affected both, with electron beam at ≥1400 Gy/s and proton ... ...

Abstract	The physico-chemical and biological response to conventional and UHDR electron and proton beams was investigated, along with conventional photons. The temporal structure and nature of the beam affected both, with electron beam at ≥1400 Gy/s and proton beam at 0.1 and 1260 Gy/s found to be isoefficient at sparing zebrafish embryos.
MeSH term(s)	Animals ; Zebrafish ; Proton Therapy ; Electrons ; Protons ; Hydrogen Peroxide ; Radiotherapy Dosage
Chemical Substances	Protons ; Hydrogen Peroxide (BBX060AN9V)
Language	English
Publishing date	2022-07-19
Publishing country	Ireland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2022.07.011
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