The deliverability and clinical benefit of proton arc therapy

使用圆弧光束提供更适形放射治疗的能力早已为人所知，现在是x射线放射治疗的最先进技术，在那里它被称为体积调制电弧疗法（VMAT）。VMAT提供的效率和剂量学优势导致VMAT治疗的比例越来越大。由于依赖于现有的加速器技术，质子的电弧治疗技术尚未实现，而加速器技术无法足够快地改变光束能量以提供范围调制的质子治疗电弧。质子弧治疗（PAT）将改变质子的剂量输送，并为优化剂量分布提供新的选择。本项目将在计算机上实施质子弧治疗，并结合相关生物学模型对质子剂量分布进行计算机建模，了解质子弧治疗的优势和要求。商业质子治疗系统的输送限制将适应于检查先进治疗硬件可能带来的新能力。这个关于优化质子弧治疗和生物效应评估的建议与EPSRC关于医疗技术的主题直接相关。具体来说，该项目解决了四大挑战中的两个。第一个是“物理干预的前沿，通过探索新的弧线疗法，通过增加病人的吞吐量来降低成本，通过更适形、更有效的疗法来降低风险。”第二是通过更有效的质子束治疗来优化治疗，改善患者的预后。

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.