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Practical Guides in Radiation Oncology Series Editors: Nancy Y. Lee · Jiade J. Lu Nancy Y. Lee · Jonathan E. Leeman Oren Cahlon · Kevin Sine Guoliang Jiang · Jiade J. Lu Stefan Both Editors Target Volume Delineation and Treatment Planning for Particle Therapy A Practical Guide Practical Guides in Radiation Oncology Series Editors Nancy Y. Lee Department of Radiation Oncology Memorial Sloan-Kettering Cancer Center New York, NY, USA Jiade J. Lu Department of Radiation Oncology Shanghai Proton and Heavy Ion Center Shanghai, China The series Practical Guides in Radiation Oncology is designed to assist radiation oncology residents and practicing radiation oncologists in the application of current techniques in radiation oncology and day-to-day management in clinical practice, i.e., treatment planning. Individual volumes offer clear guidance on contouring in different cancers and present treatment recommendations, including with regard to advanced options such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT) and proton beam therapy (PBT). Each volume addresses one particular area of practice and is edited by experts with an outstanding international reputation. Readers will find the series to be an ideal source of up-to-date information on when to apply the various available technologies and how to perform safe treatment planning. More information about this series at http://www.springer.com/series/13580 Nancy Y. Lee • Jonathan E. Leeman Oren Cahlon • Kevin Sine • Guoliang Jiang Jiade J. Lu • Stefan Both Editors Target Volume Delineation and Treatment Planning for Particle Therapy A Practical Guide Editors Nancy Y. Lee Jonathan E. Leeman Department of Radiation Oncology Department of Radiation Oncology Memorial Sloan-Kettering Cancer Center Memorial Sloan Kettering Cancer Center New York, NY New York USA USA Oren Cahlon Kevin Sine Department of Radiation Oncology Department of Medical Dosimetry Memorial Sloan Kettering Cancer Center ProCure Proton Therapy Center New York Somerset USA New Jersey USA Guoliang Jiang Department of Radiation Oncology Jiade J. Lu Shanghai Proton and Heavy Ion Center Department of Radiation Oncology Shanghai Shanghai Proton and Heavy Ion Center China Shanghai China Stefan Both Department of Radiation Oncology University Medical Center Groningen Groningen The Netherlands ISSN 2522-5715 ISSN 2522-5723 (electronic) Practical Guides in Radiation Oncology ISBN 978-3-319-42477-4 ISBN 978-3-319-42478-1 (eBook) https://doi.org/10.1007/978-3-319-42478-1 Library of Congress Control Number: 2017962011 © Springer International Publishing Switzerland 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Acknowledgments This publication is partially supported by the following grants: (a) Shanghai Hospital Development Center (Joint Breakthrough Project for New Frontier Technologies, Project No. SHDC 12015118); (b) Science and Technology Commission of Shanghai Municipality (Project No. 15411950106). v Contents 1 Physics Essentials of Particle Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Dennis Mah, Michael Moyers, Ken Kang-Hsin Wang, Eric Diffenderfer, John Cuaron, and Mark Pankuch 2 Proton Treatment Delivery Techniques . . . . . . . . . . . . . . . . . . . . . . . . . 17 Xuanfeng Ding, Haibo Lin, Jiajian Shen, Wei Zou, Katja Langen, and Hsiao-Ming Lu 3 Proton Treatment Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Chuan Zeng, Richard A. Amos, Brian Winey, Chris Beltran, Ziad Saleh, Zelig Tochner, Hanne Kooy, and Stefan Both 4 Tumors of the Nasopharynx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Jeremy Setton, Pamela Fox, Kevin Sine, Nadeem Riaz, and Nancy Y. Lee 5 Oral Cavity Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Jennifer Ma, Benjamin H. Lok, Kevin Sine, and Nancy Y. Lee 6 Oropharyngeal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Suchit H. Patel, Amy J. Xu, Kevin Sine, Nancy Y. Lee, and Pamela Fox 7 Sinonasal Cancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Roi Dagan and Curtis Bryant 8 Salivary Gland Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Jonathan E. Leeman, Paul Romesser, James Melotek, Oren Cahlon, Kevin Sine, Stefan Both, and Nancy Y. Lee 9 Thyroid Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Mauricio Gamez, Aman Anand, and Samir H. Patel 10 Non-melanoma Skin Cancer with Clinical Perineural Invasion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Curtis Bryant and Roi Dagan 11 Head and Neck Reirradiation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 Carl DeSelm, Upendra Parvathaneni, and Kevin Sine vii viii Contents 12 Lung Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Daniel Gomez, Heng Li, Xiaodong Zhang, and Steven Lin 13 Esophagus Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Steven H. Lin, Heng Li, and Daniel Gomez 14 Carbon Ion Radiation Therapy for Liver Tumors . . . . . . . . . . . . . . . 221 Zheng Wang, Wei-Wei Wang, Kambiz Shahnazi, and Guo-Liang Jiang 15 Pancreatic and Stomach Malignancies . . . . . . . . . . . . . . . . . . . . . . . . 235 Pamela J. Boimel, Jessica Scholey, Liyong Lin, and Edgar Ben-Josef 16 Lower Gastrointestinal Malignancies . . . . . . . . . . . . . . . . . . . . . . . . . 257 John P. Plastaras, Stefan Both, Haibo Lin, and Maria Hawkins 17 Breast Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271 Robert Samstein, David DeBlois, Robert W. Mutter, and Oren Cahlon 18 Gynecologic malignancies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 Jessica E. Scholey, Pamela J. Boimel, Maura Kirk, and Lilie Lin 19 Prostate Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303 Neil K. Taunk, Chin-Cheng Chen, Zhiqiang Han, Jerry Davis, Neha Vapiwala, and Henry Tsai 20 Adult Intracranial Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317 Natalie A. Lockney, Zhiqiang Han, Kevin Sine, Dominic Maes, and Yoshiya Yamada 21 Primary Spine Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329 Anuradha Thiagarajan and Yoshiya Yamada 22 Sarcoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347 Curtiland Deville, Matthew Ladra, Huifang Zhai, Moe Siddiqui, Stefan Both, and Haibo Lin 23 Mediastinal Lymphoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 Bradford S. Hoppe, Stella Flampouri, Christine Hill-Kayser, and John P. Plastaras 24 Pediatric Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381 Paul B. Romesser, Nelly Ju, Chin-Cheng Chen, Kevin Sine, Oren Cahlon, and Suzanne L. Wolden Physics Essentials of Particle Therapy 1 Dennis Mah, Michael Moyers, Ken Kang-Hsin Wang, Eric Diffenderfer, John Cuaron, and Mark Pankuch Contents 1.1 History of Light Ion Teletherapy.................................................................................... 2 1.1.1 Rationale for Light Ion Beam Teletherapy......................................................... 2 1.2 Basic Physics ................................................................................................................. 4 1.2.1 Penumbra ........................................................................................................... 4 1.2.2 In Patient ............................................................................................................ 5 1.3 Relative Biological Effectiveness (RBE) ....................................................................... 6 1.3.1 Terminology ....................................................................................................... 8 1.3.2 Ions Heavier than Protons .................................................................................. 9 1.4 Range Uncertainty ......................................................................................................... 11 D. Mah (*) ProCure New Jersey, Somerset, NJ, USA e-mail: [email protected] M. Moyers Shanghai Proton and Heavy Ion Center, Shanghai, China e-mail: [email protected] K. Kang-Hsin Wang Johns Hopkins Hospital, Baltimore, MD, USA e-mail: [email protected] E. Diffenderfer University of Pennsylvania, Philadelphia, PA, USA e-mail: [email protected] J. Cuaron Memorial Sloan Kettering Cancer Center, New York City, NY, USA e-mail: [email protected] M. Pankuch Northwestern Medicine, Chicago Proton Center, Warrenville, IL, USA e-mail: [email protected] © Springer International Publishing Switzerland 2018 1 N. Lee et al. (eds.), Target Volume Delineation and Treatment Planning for Particle Therapy, Practical Guides in Radiation Oncology, https://doi.org/10.1007/978-3-319-42478-1_1 2 D. Mah et al. 1.5 Beam Generators ............................................................................................................ 12 1.5.1 Synchrotron ........................................................................................................ 12 1.5.2 Cyclotron ............................................................................................................ 13 1.6 Future Developments ..................................................................................................... 14 1.7 References ...................................................................................................................... 15 1.1 History of Light Ion Teletherapy 1.1.1 Rationale for Light Ion Beam Teletherapy • There are three reasons for using light ion beams for teletherapy: (1) the low entrance dose and almost zero dose delivered distal to the target results in the ratio of nontarget tissue dose to target dose being smaller than with other radia- tion beams; (2) with appropriate collimation, the dose gradients at the lateral and distal sides of the targets are higher than with other radiation beams thereby offering higher dose gradients between the target and normal tissues; (3) for ions heavier than helium, the increase in RBE with increasing depth results in the target receiving a higher RBE dose than the tissues on the entrance side. • Light ions are a subset of heavy charged particles and are defined as ions with atomic numbers less than 20 [1–3]. Although six different ions have been used for human treatments, the majority of patients have been treated with protons, helium ions, and carbon ions. Figure 1.1 shows the approximate number of patients treated with different heavy charged particle beams between 1954, when Heavy Charged Particles Pions Light Ions Other Ions 1,098 136,372 22 hydrogen-1 silicon-28 118,195 20 helium-4 argon-40 2,142 2 Fig. 1.1 Approximate number of patients treated with different heavy charged carbon-12 particle beams from 1954 to 15,736 2015. Figure adapted from Vatnitsky and Moyers [4] and updated with data from neon-20 Jermann [5] to reflect recent 299 data

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