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Updated: Jan 6, 2026
08:34
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
20.9K
Multi-modality biological dose optimization for combined carbon-ion and proton radiation therapy
Chao Wang1,2, Ya-Nan Zhu2,3, Yuting Lin4
1College of Science, China Agricultural University, Beijing, China.
Medical Physics
|October 24, 2025
Summary
This study introduces a new combined proton and carbon ion radiotherapy (PT-CIRT) approach. CCIPRT enhances tumor biological dose and conformity while sparing organs at risk, outperforming single-modality treatments.
Area of Science:
- Radiation Oncology
- Medical Physics
- Biophysics
Background:
- Carbon ion radiotherapy (CIRT) offers superior dose conformity and biological effectiveness (higher RBE) compared to proton radiotherapy (PT), ideal for radioresistant tumors.
- However, CIRT's high RBE and fragmentation dose tail pose challenges for sparing organs at risk (OARs).
- Combining PT and CIRT (CCIPRT) presents a hybrid modality to leverage carbon ions' benefits while minimizing normal tissue toxicity.
Purpose of the Study:
- To develop an optimized treatment planning approach for combining proton and carbon ion radiotherapy (CCIPRT).
- To automatically adjust the relative contributions of protons and carbon ions to improve target dose conformity.
- To minimize the biological impact on organs at risk (OARs) in the combined modality.
Main Methods:
- A biological optimization framework for multi-modality CCIPRT was proposed, modeling biological dose as physical dose multiplied by relative biological effectiveness (RBE).
- Iterative Jacobian-based linearization and convex relaxation with the alternating direction method of multipliers were used to solve the joint optimization problem.
- Single-modality PT and CIRT were implemented for comparison.
Main Results:
- CCIPRT increased the mean biological dose in the target by 29.6–37.7% compared to PT and reduced biological dose in a surrounding ring by 32.3–47.2% compared to CIRT.
- When prescribed biologically, CCIPRT achieved higher conformity (0.96–0.97) and reduced surrounding dose by 7.0–9.5% compared to PT.
- CCIPRT enhanced healthy tissue sparing, reducing the whole-body dose by 7.5–9.2% compared to CIRT.
Conclusions:
- A novel multi-modality CCIPRT treatment planning system was developed.
- CCIPRT demonstrated superior performance over single-modality PT and CIRT.
- The approach offers enhanced biological effectiveness and dose conformity compared to PT, with reduced OAR dose compared to CIRT.
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