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Particle Therapy for the Treatment of Brain Metastases

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Radiotherapy in Managing Brain Metastases

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Abstract

Proton beam therapy (PBT) has a dosimetric advantage compared with photon radiotherapy due to its ability to stop within tissues at a desired depth. PBT is best utilized in clinical scenarios where this increased conformality may lead to improved toxicities and/or facilitate treatments that would otherwise be unsafe with photons. For brain metastases in cases where stereotactic radiosurgery (SRS) is indicated, photon SRS is an excellent treatment modality and can often produce highly conformal radiation plans. Given that treatment with proton SRS is more complex and costlier than photon SRS, many question the role of PBT in the treatment of brain metastases. In this chapter, we will review the basics of PBT physics, biology, and dosimetry; we will examine the primary literature of proton-SRS for brain metastases; and we will discuss those patients with brain metastases for whom PBT may be helpful.

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Abbreviations

ASL:

Acute Severe Lymphopenia

CIT:

Carbon Ion Therapy

IMPT:

Intensity Modulated Proton Therapy

IMRT:

Intensity Modulated Radiation Therapy

LET:

Linear Energy Transfer

MGH:

Massachusetts General Hospital

PBS:

Pencil Beam Scanning

PBT:

Proton Beam Therapy

PSP:

Passively Scattered Protons

RBE:

Relative Biological Effectiveness

SOBP:

Spread-Out Bragg Peak

SRS:

Stereotactic Radiosurgery

VMAT:

Volumetric Modulated Arc Therapy

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA

    Jeremy Brownstein

  2. Department of Radiation Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA

    Jeremy Brownstein

  3. College of Medicine, Seoul National University, Seoul, South Korea

    Hooney D. Min

  4. Stereotactic Physics, Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA

    Marc Bussiere

  5. Proton Therapy Centers, Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA

    Helen A. Shih

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  1. Jeremy Brownstein
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  2. Hooney D. Min
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  3. Marc Bussiere
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  4. Helen A. Shih
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Corresponding author

Correspondence to Jeremy Brownstein .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Yoshiya Yamada

  2. Department of Radiation Oncology, University of Southern California, Los Angeles, CA, USA

    Eric Chang

  3. Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL, USA

    John B. Fiveash

  4. Weill Cornell Medicine, NewYork–Presbyterian Hospital, New York, NY, USA

    Jonathan Knisely

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Brownstein, J., Min, H.D., Bussiere, M., Shih, H.A. (2020). Particle Therapy for the Treatment of Brain Metastases. In: Yamada, Y., Chang, E., Fiveash, J., Knisely, J. (eds) Radiotherapy in Managing Brain Metastases. Springer, Cham. https://doi.org/10.1007/978-3-030-43740-4_13

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  • DOI: https://doi.org/10.1007/978-3-030-43740-4_13

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-43740-4

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