Particle Therapy 2017

“Lessons learned” from the ongoing MGH/MDACC Phase III NSCLC trial (approx. 150 patients presently accrued) ➢ peer review of contours is critical; ➢ image guidance with daily kV imaging and weekly CT scans is very important; ➢ modifications to treatment plans to adapt to changes in tumor or anatomy were needed in 20% of IMRT cases and 55% of proton cases* ➢ ~ 70% of all patients could be randomized, and among the randomized patients, 75% were at 74 Gy (RBE) and 25% at 66 Gy (RBE) dose levels; ➢ among patients for whom the plan could not meet the stipulated dose constraints, the modality that achieved higher target dose without violating dose-volume constraints was used to deliver the treatment ➢ the rate of treatment interruption or incompletion has been extremely low. ➢ early findings suggest that the outcomes in both the IMRT and proton groups are better than those of historical controls .

*Note: personal experience only about 10%