A Proton Therapy Overview Richard Eckart And David Turberville Richard Eckart And David Turberville

Modality Method and How It Works  Three Dimensional- Tumor Conformity  Bragg Peak Effect  Lower dose to normal tissue  No exit dose  Maximum Energy Deposit  Increase dose deposited  Three Dimensional- Tumor Conformity  Bragg Peak Effect  Lower dose to normal tissue  No exit dose  Maximum Energy Deposit  Increase dose deposited

Cancers Treated  Prostate Cancer- Highly effective  CNS Tumors- Minimizes unwanted dose  Ocular Cancers  Lung Cancers  GI Cancers  Pediatric Cancers- Growth Development  Prostate Cancer- Highly effective  CNS Tumors- Minimizes unwanted dose  Ocular Cancers  Lung Cancers  GI Cancers  Pediatric Cancers- Growth Development

Effectiveness/Results  Inconsistent Data from Clinical Trials  Constantly Changing Technology  Worldwide Collaboration  Rapid exchange of information  Validation of current technology  Long Term Documentation  Not enough collected at this time  Inconsistent Data from Clinical Trials  Constantly Changing Technology  Worldwide Collaboration  Rapid exchange of information  Validation of current technology  Long Term Documentation  Not enough collected at this time

Benefits and Drawbacks  Can still be combined with other treatment modalities  Health Insurance  Coverage  Medicare currently covers treatments  Cost  All or Nothing Approach-100% or 0% dose delivered  Can still be combined with other treatment modalities  Health Insurance  Coverage  Medicare currently covers treatments  Cost  All or Nothing Approach-100% or 0% dose delivered

Advantages  Fine tuned targeting of the beam  Utilizes pencil beam scanning  Even with IMRT there is a Leaf stepping effect  Treating small volumes and minimal depths- Ex. Eye  Reducing the risk of secondary malignancies  Quality of life  Pediatrics  Fine tuned targeting of the beam  Utilizes pencil beam scanning  Even with IMRT there is a Leaf stepping effect  Treating small volumes and minimal depths- Ex. Eye  Reducing the risk of secondary malignancies  Quality of life  Pediatrics

Patients Eligible and Sites Available  As of fall 2012, there are 10 centers operating in the U.S.  8 more centers being developed  Cost limitations have resulted in a severe shortage in capacity. 137,000 patients each year stand to benefit from proton therapy. Only 11,270 can currently be treated.  As of fall 2012, there are 10 centers operating in the U.S.  8 more centers being developed  Cost limitations have resulted in a severe shortage in capacity. 137,000 patients each year stand to benefit from proton therapy. Only 11,270 can currently be treated.

Current & Future Research Considerations  More research becoming available for comparison:  Side effects- acute and chronic  Survival rates  Secondary malignancies  Quality of Life  More research becoming available for comparison:  Side effects- acute and chronic  Survival rates  Secondary malignancies  Quality of Life

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