The deliverability and clinical benefit of proton arc therapy

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The power of delivering more conformal radiotherapy treatments using circular arcs of beams has been known for a long time and is now state of the art for x-ray radiotherapy, where it is called Volumetric Modulated Arc Therapy (VMAT). The efficiency and dosimetric advantages that are afforded by VMAT are resulting in an increasing proportion of VMAT treatments. Arc therapy technology has not been implemented for protons due to the reliance on existing accelerator technology, which cannot change the beam energy fast enough to deliver a range modulated proton therapy arc. Proton arc therapy (PAT) will change the dosimetric delivery of protons and enable new options for the optimisation of dose distributions. This project will implement Proton Arc Therapy in silico, and use in silico modelling of proton dose distributions in combination with relevant biological models to understand the advantages and requirements of proton arc therapy. The delivery constraints in commercial proton therapy systems will be adapted to examine the new capabilities possible from advanced treatment hardware. This proposal on optimising proton arc therapy and the assessment of the biological effects is directly linked to the EPSRC theme on healthcare technologies. Specifically, the project tackles two of the four grand challenges. The first is "Frontiers of Physical Intervention through the exploration of novel arc therapy which will reduce cost through increased patient throughput and reduced risk through more conformal, robust therapies. The second is optimising treatment through more effective proton beam therapy, improving patient outcome.