Basic Clinical Radiobiology 2017

PROTON THERAPY INDICATIONS

REGION

LESION

Isolated brain metastases Selected brain tumor recurrences Pituitary adenomas Arteriovenous malformations (AVMs) Meningiomas Acoustic neuromas Chordomas and chondrosarcomas

Brain and spinal cord

Base of skull

Uveal melanomas Macular degeneration

Eye

Nasopharynx (primary and recurrent) tumors Oropharynx (locally advanced) tumors Paranasal sinus tumors Medically inoperable non-small-cell lung cancer Chordomas and chondrosarcomas Hepatic tumors Retroperitoneal tumors Paraspinal tumors Prostate tumors Chordomas and chondrosarcomas Brain and spinal cord tumors Orbital and ocular tumors Sarcomas of the base of skull and spine Abdominal and pelvic tumors

Head and neck

Chest and abdomen

Pelvis

Pediatric lesions

ESTRO 2017

Suit, 2010

Comparison between CRT and SBRT for stage I NSCLC Retrospective single arm studies: 1994-2008 30 studies included (2611 patients, published data)

Treatment

#pts

EQD 2,T

(Gy)

#Fractions

CRT

1326

42-63

20-43

SBRT

895

33-176

3-10

Protons

180

63-111

2-6

ESTRO 2017

Grutterset al., 2009

Randomized phase III trials with proton therapy published as of August 2017

ESTRO 2017

Shipley et al., 1995

14