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Advances in Proton Therapy for Head and Neck Cancer: Techniques,...
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Advances in Proton Therapy for Head and Neck Cancer: Techniques, Outcomes and Planning Variations

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 1503

Special Issue Editor

Dr. Jun Zhou

E-Mail Website
Guest Editor
Emory Proton Therapy Center, Department of Radiation Oncology, Emory University, Atlanta, GA, USA
Interests: adaptive proton therapy; proton FLASH therapy; proton SBRT

Special Issue Information

Dear Colleagues,

Proton therapy has emerged as a promising treatment option for head and neck (HN) cancer, primarily due to its superior dosimetry in sparing critical normal tissues. This Special Issue aims to explore recent developments in proton therapy, focusing on novel techniques, treatment outcomes in comparison to photon therapy, and the variation in treatment planning techniques across different centers.

The scope and goals of this Special Issue include (a) novel techniques in proton HN treatment; (b) outcomes of proton HN treatment vs. photon treatment; (c) treatment planning techniques and planning goals; and (d) adaptation in proton HN therapy.

This Special Issue aims to provide a comprehensive overview of the current landscape of proton therapy for head and neck cancer, covering new techniques, treatment outcomes, planning variations, and adaptation strategies. By bringing together diverse perspectives and research findings, it seeks to contribute to the ongoing dialogue in the field and guide future advancements in proton therapy for head and neck cancer.

Dr. Jun Zhou
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • proton head and neck cancer therapy
  • protons vs. photons for head and neck cancer treatment
  • adaptive proton therapy
  • robustness in proton head and neck cancer therapy
  • online vs. offline adaptation in proton head and neck cancer therapy

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Published Papers (2 papers)

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Research

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16 pages, 1300 KiB  
Article
Proton Therapy Adaptation of Perisinusoidal and Brain Areas in the Cyclotron Centre Bronowice in Krakow: A Dosimetric Analysis
by Marzena Rydygier, Tomasz Skóra, Kamil Kisielewicz, Anna Spaleniak, Magdalena Garbacz, Monika Lipa, Gabriela Foltyńska, Eleonora Góra, Jan Gajewski, Dawid Krzempek, Renata Kopeć and Antoni Ruciński
Cancers 2024, 16(18), 3128; https://doi.org/10.3390/cancers16183128 - 11 Sep 2024
Viewed by 718
Abstract
Applying a proton beam in radiotherapy enables precise irradiation of the tumor volume, but only for continuous assessment of changes in patient anatomy. Proton beam range uncertainties in the treatment process may originate not only from physical beam properties but also from patient-specific [...] Read more.
Applying a proton beam in radiotherapy enables precise irradiation of the tumor volume, but only for continuous assessment of changes in patient anatomy. Proton beam range uncertainties in the treatment process may originate not only from physical beam properties but also from patient-specific factors such as tumor shrinkage, edema formation and sinus filling, which are not incorporated in tumor volume safety margins. In this paper, we evaluated variations in dose distribution in proton therapy resulting from the differences observed in the control tomographic images and the dosimetric influence of applied adaptive treatment. The data from weekly computed tomography (CT) control scans of 21 patients, which serve as the basis for adaptive radiotherapy, were used for this study. Dosimetric analysis of adaptive proton therapy (APT) was performed on patients with head and neck (H&N) area tumors who were divided into two groups: patients with tumors in the sinus/nasal area and patients with tumors in the brain area. For this analysis, the reference treatment plans were forward-calculated using weekly control CT scans. A comparative evaluation of organ at risk (OAR) dose-volume histogram (DVH) parameters, as well as conformity and homogeneity indices, was conducted between the initial and recalculated dose distributions to assess the necessity of the adaptation process in terms of dosimetric parameters. Changes in PTV volume after replanning were observed in seventeen patient cases, showing a discrepancy of over 1 cm3 in ten cases. In these cases, tumor progression occurred in 30% of patients, while regression was observed in 70%. The statistical analysis indicates that the use of the adaptive planning procedure results in a statistically significant improvement in dose distribution, particularly in the PTV area. The findings led to the conclusion that the adaptive procedure provides significant advantages in terms of dose distribution within the treated volume. However, when considering the entire patient group, APT did not result in a statistically significant dose reduction in OARs (α = 0.05). Full article
(This article belongs to the Special Issue Advances in Proton Therapy for Head and Neck Cancer: Techniques, Outcomes and Planning Variations)
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Review

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13 pages, 4605 KiB  
Review
The Potential and Challenges of Proton FLASH in Head and Neck Cancer Reirradiation
by Chingyun Cheng, Liming Xu, Hao Jing, Balaji Selvaraj, Haibo Lin, Michael Pennock, Arpit M. Chhabra, Shaakir Hasan, Huifang Zhai, Yin Zhang, Ke Nie, Richard L. Bakst, Rafi Kabarriti, J. Isabelle Choi, Nancy Y. Lee, Charles B. Simone II, Minglei Kang and Hui Wu
Cancers 2024, 16(19), 3249; https://doi.org/10.3390/cancers16193249 - 24 Sep 2024
Viewed by 452
Abstract
Ultrahigh-dose-rate therapy, also known as FLASH radiotherapy (RT), is an emerging technique that is garnering significant interest in cancer treatment due to its potential to revolutionize therapy. This method can achieve comparable tumor control to conventional-dose-rate RT while offering the enhanced protection of [...] Read more.
Ultrahigh-dose-rate therapy, also known as FLASH radiotherapy (RT), is an emerging technique that is garnering significant interest in cancer treatment due to its potential to revolutionize therapy. This method can achieve comparable tumor control to conventional-dose-rate RT while offering the enhanced protection of normal tissue through the FLASH-sparing effect. This innovative technique has demonstrated promising results in preclinical studies involving animals and cell lines. Particularly noteworthy is its potential application in treating head and neck (HN) cancers, especially in patients with challenging recurrent tumors and reirradiation cases, where the toxicity rates with conventional radiotherapy are high. Such applications aim to enhance tumor control while minimizing side effects and preserving patients’ quality of life. In comparison to electron or photon FLASH modalities, proton therapy has demonstrated superior dosimetric and delivery characteristics and is a safe and effective FLASH treatment for human malignancies. Compared to the transmission proton FLASH, single-energy Bragg peak FLASH is a novel delivery method that allows highly conformal doses to targets and minimal radiation doses to crucial OARs. Proton Bragg peak FLASH for HN cancer has still not been well studied. This review highlights the significance of proton FLASH in enhancing cancer therapy by examining the advantages and challenges of using it for HN cancer reirradiation. Full article
(This article belongs to the Special Issue Advances in Proton Therapy for Head and Neck Cancer: Techniques, Outcomes and Planning Variations)
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