Optimal combined proton-photon therapy schemes based on the standard BED model

Area of Science:

• Radiation Oncology
• Medical Physics

Background:

• Proton therapy is a specialized radiation treatment with increasing availability but high costs.
• Optimizing radiation therapy requires careful consideration of dose delivery and fractionation schedules.

Purpose of the Study:

• To investigate the efficacy of combined proton-photon therapy schemes, focusing on fractionation.
• To determine conditions under which combined modality treatments offer added value compared to single-modality approaches.

Main Methods:

• Analytical and numerical modeling of combined modality treatment schemes.
• Formulation of the optimal fractionation problem using the biologically effective dose (BED) model.
• Testing models on patient data for combined modality treatments.

Main Results:

• Combined proton-photon therapy can yield superior biological dose improvements (up to [Formula: see text]) compared to single-modality proton treatments for some patients.
• Alternative combined modality treatments were identified that are marginally less effective but use significantly fewer proton fractions.
• This approach can alleviate pressure on limited proton therapy resources.

Conclusions:

• Combined proton-photon therapy is a viable and potentially important treatment strategy in radiation oncology.
• This approach offers benefits in terms of biological dose and resource utilization, especially given the expanding network of proton therapy centers and their associated costs.