Michael Patrick Russell Waligórski

CALCULATION OF RELATIVE BIOLOGICAL EFFECTIVENESS FOR PROTON BEAMS USING BIOLOGICAL WEIGHTING FUNCTIONS

PURPOSE The microdosimetric weighting function approach is used widely for beam comparison studies. The suitability of this model to predict the relative biological effectiveness (RBE) of therapeutic proton beams was studied. The RBE(alpha) (i.e., linear approximation) dependence on the type of biological end point, initial proton energy, energy spread of the input proton beam, and depth of beam penetration was investigated. METHODS AND MATERIALS Proton transport calculations for a proton energy range from 70 to 250 MeV were performed to obtain proton energy spectra at a given depth. The corresponding microdosimetric distributions of lineal energy were calculated. To these distributions the biological response function approach was applied to calculate RBE(alpha) the biological effectiveness based on a linear dose-response relationship. The early intestinal tolerance assessed by crypt regeneration in mice and the inactivation of V79 cells were taken as biological end points. RESULTS The RBE(alpha) values approach about 1 in the plateau region and gradually increase with the proton penetration depth. In the center of the Bragg peak, at the maximum dose delivery, the values of RBE(alpha) range from 1.1 (250-MeV beam, early intestinal tolerance in mice) to 1.9 (70-MeV beam, Chinese hamster V79 cells in G1/S phase). Distal to the Bragg peak, where only a small fraction of dose is delivered, the RBE(alpha) was found to be even higher. For modulated proton beams we found an increasing RBE(alpha) with depth in the spread-out Bragg peak (SOBP). Values up to 1.37 at the distal end of the SOBP plateau (155-MeV beam, SOBP between 5.3 and 13.2 cm) were obtained. CONCLUSION More experimental work on the determination of microdosimetric weighting functions is needed. The results of the presented calculations indicate that for therapy planning it may be necessary to account for a depth dependence on proton RBE, especially for lower energy.

The updated ESTRO core curricula 2011 for clinicians, medical physicists and RTTs in radiotherapy/radiation oncology

INTRODUCTION In 2007 ESTRO proposed a revision and harmonisation of the core curricula for radiation oncologists, medical physicists and RTTs to encourage harmonised education programmes for the professional disciplines, to facilitate mobility between EU member states, to reflect the rapid development of the professions and to secure the best evidence-based education across Europe. MATERIAL AND METHODS Working parties for each core curriculum were established and included a broad representation with geographic spread and different experience with education from the ESTRO Educational Committee, local representatives appointed by the National Societies and support from ESTRO staff. RESULTS The revised curricula have been presented for the ESTRO community and endorsement is ongoing. All three curricula have been changed to competency based education and training, teaching methodology and assessment and include the recent introduction of the new dose planning and delivery techniques and the integration of drugs and radiation. The curricula can be downloaded at http://www.estro-education.org/europeantraining/Pages/EuropeanCurricula.aspx. CONCLUSION The main objective of the ESTRO core curricula is to update and harmonise training of the radiation oncologists, medical physicists and RTTs in Europe. It is recommended that the authorities in charge of the respective training programmes throughout Europe harmonise their own curricula according to the common framework.

Proton microbeam radiotherapy with scanned pencil-beams – Monte Carlo simulations

Irradiation, delivered by a synchrotron facility, using a set of highly collimated, narrow and parallel photon beams spaced by 1 mm or less, has been termed Microbeam Radiation Therapy (MRT). The tolerance of healthy tissue after MRT was found to be better than after standard broad X-ray beams, together with a more pronounced response of malignant tissue. The microbeam spacing and transverse peak-to-valley dose ratio (PVDR) are considered to be relevant biological MRT parameters. We investigated the MRT concept for proton microbeams, where we expected different depth-dose profiles and PVDR dependences, resulting in skin sparing and homogeneous dose distributions at larger beam depths, due to differences between interactions of proton and photon beams in tissue. Using the FLUKA Monte Carlo code we simulated PVDR distributions for differently spaced 0.1 mm (sigma) pencil-beams of entrance energies 60, 80, 100 and 120 MeV irradiating a cylindrical water phantom with and without a bone layer, representing human head. We calculated PVDR distributions and evaluated uniformity of target irradiation at distal beam ranges of 60-120 MeV microbeams. We also calculated PVDR distributions for a 60 MeV spread-out Bragg peak microbeam configuration. Application of optimised proton MRT in terms of spot size, pencil-beam distribution, entrance beam energy, multiport irradiation, combined with relevant radiobiological investigations, could pave the way for hypofractionation scenarios where tissue sparing at the entrance, better malignant tissue response and better dose conformity of target volume irradiation could be achieved, compared with present proton beam radiotherapy configurations.

Measurement of stray neutron doses inside the treatment room from a proton pencil beam scanning system

PURPOSE To measure the environmental doses from stray neutrons in the vicinity of a solid slab phantom as a function of beam energy, field size and modulation width, using the proton pencil beam scanning (PBS) technique. METHOD Measurements were carried out using two extended range WENDI-II rem-counters and three tissue equivalent proportional counters. Detectors were suitably placed at different distances around the RW3 slab phantom. Beam irradiation parameters were varied to cover the clinical ranges of proton beam energies (100-220MeV), field sizes ((2×2)-(20×20)cm2) and modulation widths (0-15cm). RESULTS For pristine proton peak irradiations, large variations of neutron H∗(10)/D were observed with changes in beam energy and field size, while these were less dependent on modulation widths. H∗(10)/D for pristine proton pencil beams varied between 0.04μSvGy-1 at beam energy 100MeV and a (2×2)cm2 field at 2.25m distance and 90° angle with respect to the beam axis, and 72.3μSvGy-1 at beam energy 200MeV and a (20×20) cm2 field at 1m distance along the beam axis. CONCLUSIONS The obtained results will be useful in benchmarking Monte Carlo calculations of proton radiotherapy in PBS mode and in estimating the exposure to stray radiation of the patient. Such estimates may be facilitated by the obtained best-fitted simple analytical formulae relating the stray neutron doses at points of interest with beam irradiation parameters.

Cellular parameters and RBE-LET dependences for modelling heavy-ion radiotherapy

Sets of four parameters (m, E0, sigma0 and kappa) of the cellular track structure model of Katz have been fitted to recently published data concerning human melanoma (AA) and mammalian (V79) cells exposed to a variety of lighter ions and to mixed ion-Co60 and ion-ion irradiation. Using these parameters, model predictions of V79 survival were verified against experimental data. RBE-LET dependences were calculated and compared with experimental data obtained for V79 cells after exposure to 3He, 12C and 20Ne ion beams. The presented track-segment approach used in track structure calculations, while satisfactory for heavier ions, may be of limited value for predicting the RBE-LET dependence of proton and helium radiotherapy beams in regions close to the distal range of these particles. We discuss the predictive capability of this model and propose standards in reporting cellular radiobiology data for application in modelling heavy ion beam radiotherapy.

Application of alanine dosimetry in dose assessment for ocular melanoma patients undergoing proton radiotherapy – preliminary results

Abstract Basing on alanine solid state/electron paramagnetic resonance (EPR) dosimetry, a supplementary method of cumulatively recording the therapeutic dose received by ocular cancer patients undergoing fractionated proton radiotherapy is proposed. By applying alanine dosimetry during the delivery of consecutive fractions, the dose received within each fraction can be read out by EPR spectrometry and a final permanent cumulative record of the total dose delivered obtained. The dose response of the alanine detector was found to be practically independent on its position within the extended proton Bragg peak region. Dose measurements based on entrance dose recorded in proton beams individually formed for each patient are presented. The described method will be applied as a complementary Quality Assurance procedure for patients undergoing proton radiotherapy at the Institute of Nuclear Physics, Polish Academy of Sciences, Krakow, Poland (IFJ PAN).

Studies of scintillator response to 60 MeV protons in a proton beam imaging system

Abstract A Proton Beam Imaging System (ProBImS) is under development at the Institute of Nuclear Physics, Polish Academy of Sciences (IFJ PAN). The ProBImS will be used to optimize beam delivery at IFJ PAN proton therapy facilities, delivering two-dimensional distributions of beam profiles. The system consists of a scintillator, optical tract and a sensitive CCD camera which digitally records the light emitted from the proton-irradiated scintillator. The optical system, imaging data transfer and control software have already been developed. Here, we report preliminary results of an evaluation of the DuPont Hi-speed thick back screen EJ 000128 scintillator to determine its applicability in our imaging system. In order to optimize the light conversion with respect to the dose locally deposited by the proton beam in the scintillation detector, we have studied the response of the DuPont scintillator in terms of linearity of dose response, uniformity of light emission and decay rate of background light after deposition of a high dose in the scintillator. We found a linear dependence of scintillator light output vs. beam intensity by showing the intensity of the recorded images to be proportional to the dose deposited in the scintillator volume.