A 10-Year Patterns of Use Analysis for the World's First Commercial Compact Pencil Beam Scanning Proton Therapy...

Area of Science:

• Oncology
• Medical Physics
• Radiation Therapy

Background:

• Miniaturization of treatment delivery systems has democratized pencil beam scanning proton therapy (PBS-PBT).
• The first commercial compact PBS-PBT system was installed in September 2014 at a community health center.
• This study details the ten-year experience with this pioneering system.

Purpose of the Study:

• To evaluate the clinical feasibility and utilization trends of the world's first compact PBS-PBT system over a decade.
• To assess the impact of external factors, such as the COVID-19 pandemic, on PBS-PBT treatment delivery.
• To analyze patient demographics, treatment sites, and fractionation patterns.

Main Methods:

• Review of patient records for those initiating PBS-PBT between September 2014 and September 2024.
• Collection of demographic and treatment planning data for each treatment course.
• Application of Pearson correlation to identify trends in fractionation over time.

Main Results:

• A total of 1382 PBS-PBT courses were initiated over ten years, with an average of 138.2 courses annually.
• Prostate and brain were the most frequently treated sites. Reirradiation and stereotactic ablative radiation therapy (SABR) settings were utilized.
• Pearson correlation revealed a significant decrease in fractionation over time (r=-0.25, p<0.01), with nearly 90% of patients residing within a 100-mile radius.

Conclusions:

• The compact PBS-PBT system demonstrated stable utilization patterns and longevity in a community hospital setting, even during the COVID-19 pandemic.
• Hypofractionation trends have reduced treatment duration and potential financial toxicity for patients.
• Continued evidence generation and supportive health policies are expected to drive further expansion of PBS-PBT indications.