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Updated: Jun 26, 2026

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Published on: February 6, 2019

Upright 3D treatment planning using a vertical CT.

Anand P Shah¹, Jonathan B Strauss, Michael C Kirk

¹Department of Radiation Oncology, Rush University Medical Center, Chicago, IL 60612, USA. anand_shah@rush.edu

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists

|February 3, 2009

Summary

This study introduces a new method for upright external beam radiation therapy. This technique enabled treatment for a patient with thymic carcinoma who could not tolerate the standard supine position.

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Area of Science:

Radiation Oncology
Medical Physics
Thoracic Oncology

Background:

External beam radiation therapy (EBRT) is a cornerstone of cancer treatment.
Patient positioning is critical for accurate radiation delivery and minimizing dose to organs at risk.
Standard EBRT positioning typically involves the supine or prone position.

Observation:

A patient with thymic carcinoma required reirradiation but could not tolerate the supine position due to diaphragmatic paralysis.
Computed tomography (CT) imaging was performed in the upright position to facilitate treatment planning.
A custom immobilization chair was developed to ensure reproducible patient setup in the upright position.

Findings:

A novel technique for planning and delivering upright EBRT was successfully implemented.
The treatment plan delivered 24 Gy to the target volume while adhering to normal tissue constraints.
Port films confirmed the reproducibility of patient setup using the custom chair.

Implications:

This technique offers a viable alternative for patients unable to tolerate conventional radiation therapy positioning.
Upright positioning may improve treatment tolerance and adherence for select patient populations.
Further research into upright EBRT could expand treatment options in radiation oncology.