Abstract
This review article provides a systematic overview of the currently available evidence on the clinical effectiveness of particle therapy for the treatment of non-small cell lung cancer and summarizes findings of in silico comparative planning studies. Furthermore, technical issues and dosimetric uncertainties with respect to thoracic particle therapy are discussed.
Highlights
Over the last few decades, improvements in surgical techniques andradiotherapy have increased the survival rate in patients with lung cancer [1]
Dosimetric advantages of protons over photons have been demonstrated across non-small cell lung cancer (NSCLC) stages of disease in reducing doses to critical organs at risk, including the lungs, heart, esophagus, and spinal cord
proton beam therapy (PBT) has been used clinically in an increasing number of prospective studies for both stage I NSCLC and locally advanced NSCLC with a generally more favorable toxicity profile than what has been reported with historical photon studies
Summary
Over the last few decades, improvements in surgical techniques and (chemo)radiotherapy have increased the survival rate in patients with lung cancer [1]. Prior studies have suggested that a higher tumor dose can result in increased locoregional control, and in an improved disease-specific survival [3, 4]. There are, several difficulties with the delivery of particle beams to a tumor in the lung. These include the fact that the tumor and other anatomy may be moving, that variations exist in the water equivalent thickness of the beam path, and that the range uncertainties associated with pencil beam scanning (PBS) techniques are sensitive to motion and setup errors [9, 10]
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