ESTRO 2022 - Abstract Book

S615

Abstract book

ESTRO 2022

Abstract not available

SP-0686 For the radiologist: How AI has impacted radiology

V. Goh

United Kingdom Abstract not available Joint Debate: ESTRO-PROS: This house believes that proton therapy is the standard of care for paediatric patients, adolescents and young adults requiring radiotherapy

SP-0688 For the motion

A. Mahajan 1

1 Mayo Clinic, Radiation Oncology, Rochester, USA

Abstract Text Hypothesis : Proton therapy is the standard of care for pediatric patients, adolescents and young adults who require radiotherapy for many reasons. Methods : Review the unique physical characteristics of particle therapy and interactions in the patient. Consider accomplishments, challenges and hurdles in delivery of treatment for children. Results : Particle therapy has a property of the Bragg peak that describes the rapid fall off of energy deposition in patients. This allows massive reduction in unnecessary dose to the patient which will be associated with fewer immediate and late side effects for vulnerable populations. In comparison to x-ray based radiation plans, proton plans always has a smaller low radiation dose bath that is associated with excess morbidity without compromise of therapeutic dose to the tumor. Proton therapy delivery technology is more complicated that typical x-ray treatment machines; however, with a concerted effort between experienced clinicians and physicists who have had a strong commitment to efficiency, cost reduction, and safety there has been increased availability, confidence and technological advances that have led to excellent outcomes. Conclusion : Proton therapy has a irrefutable advantage over x-ray therapy by virtua of its physical properties and interactions with matter. With the current and future proton therapy technology and increasing availability, it should be the standard of care for these vulnerable populations when considering the optimal therapeutic index.

SP-0689 Against the motion

G. Janssens

The Netherlands Abstract not available

SP-0690 For the motion (rebuttal)

B. Timmermann 1

1 Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Centre (WTZ), Germany, German Cancer Consortium (DKTK), Essen, Germany Abstract Text Hypothesis: Proton therapy is the standard of care for pediatric patients, adolescents and young adults who require radiotherapy for many reasons. Methods: Review the data on clinical benefits when using proton therapy in childhood cancer with regard to tumor control, risk for second primary cancer (SPC) and other late effects. Results: Proton beam therapy (PBT) was used in clinical practice since the 1950’s. Early on, dose comparison studies demonstrated massive normal tissue sparing benefits. Clinical evidence demonstrated that dose escalation using PBT was feasible, safe and effective (i.e. in Chordomas, Chondrosarcomas), and the data was superior when compared to photon based external beam radiotherapy (XRT). Over the last few decades an increasing proportion of children with cancer, especially patients with CNS tumours or sarcomas, have been treated with PBT. Clinical experience with acute and late effects, i.e. cytopenias, SPC, dysphagia, endocrine outcomes, quality of life and secondary tumors have demonstrated the superiority of PBT in comparison to XRT. As initially hypothed for medulloblastoma, these findings also support a huge cost effectiveness favouring PBT. In accordance with these findings,