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Pencil beam scanning: The proton therapy innovation of the future

March 06, 2017
Rad Oncology Proton Therapy
From the March 2017 issue of HealthCare Business News magazine

Proton therapy has traditionally used a technique called uniform scanning or double scatter, which relied on physical structures (compensators and apertures) to shape the proton beam around the tumor and limit penetration through the tumor. PBS instead uses a magnet to scan the beamlet and fill in the shape of the tumor. This means a reduction in the time it takes to deliver proton therapy to patients. More importantly, it allows us to shape the proton beam around a target and even further avoid delivering unnecessary radiation to healthy organs nearby.

In other words, it helps to get cancer-blasting beams into the nooks and crannies of complex or irregularly-shaped tumors. While every cancer case is assessed on an individual basis to determine what treatment and radiation course is best, there are some tumor types that can particularly benefit from the ultra-precision of PBS.

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• Tumors in the brain, skull base and near/on the eye are very complicated to treat because of the adjacent structures and tissue. PBS can enable radiation oncologists to effectively treat the tumor with less chance of impacting cognitive abilities, vision and motor skills.

• PBS is used a great deal for prostate cancer because the prostate is located in the highly sensitive spot between the bladder and rectum. Many men undergoing treatment for prostate cancer are concerned with side effects such as gastrointestinal issues, incontinence and impotence, which are all a risk with several other treatment options. PBS gives us a better shot at avoiding those issues, which can cause men a great deal of physical and emotional difficulty.

• PBS can be beneficial for some breast cancer cases, particularly when the tumor is in the left breast. Studies have shown that traditional radiation in left-sided breast cancer cases can sometimes cause cardiac issues later in life due to the tumor’s proximity to the heart. PBS’ precision can circumvent radiation to the heart, which is especially important for younger women who have many years ahead of them.

• Pediatric cancers are among the most sensitive cases we confront, since children are still developing. Radiation to the brain, one of the most common locations of pediatric tumors, poses a risk of developmental and cognitive delays. PBS, like with other cancer types, protects critical tissue, and also reduces the likelihood of secondary malignancies later in life.

• Another treatment path to consider for PBS is with cancer recurrence. For someone who has previously had cancer and been treated with traditional radiation, undergoing that radiation course again can either pose major health risks or be altogether not recommended. Proton therapy, and specifically PBS, can be an option for some of these patients because of its tissue-sparing capability.

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