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Updated: Mar 21, 2026
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
A 10-Year Patterns of Use Analysis for the World's First Commercial Compact Pencil Beam Scanning Proton Therapy
Yohan A Walter1, Hsinshun T Wu2, Michael Durci2
1Department of Radiation Oncology, Willis Knighton Cancer Center, Shreveport, Louisiana; Clinical Research Department, University of Jamestown, Fargo, North Dakota.
Purpose:
The miniaturization of treatment delivery systems has accelerated the global democratization of pencil beam scanning (PBS) proton beam therapy (PBT). The first clinically installed commercial compact PBS-PBT system was brought online in September 2014 at the Willis Knighton Cancer Center, part of a community health system. Here, we detail our 10-year experience with the world's first compact PBS-PBT system.
Methods And Materials:
Records of patients initiating PBT between September 2014 and September 2024 were reviewed. Patient demographic and treatment planning data were collected for each treatment course. Pearson correlation was used to assess trends over time.
Results:
A total of 1382 PBT courses were initiated over the 10 years. On average, 138.2 ± 29.3 courses were treated annually. Year 10 had the most treated courses (N = 188), whereas only 114 courses were treated in year 8, partially because of an unexpected 3-month machine downtime. A total of 415 courses were initiated during the COVID-19 pandemic (March 2020-May 2023). In each year, the prostate was the most treated body site (N = 582 total), followed in most years by the brain (N = 208 total). A total of 121 courses used PBT in a reirradiation setting. Thirty-seven courses used PBT in a stereotactic ablative radiation therapy setting, although 20 of these courses were treated in year 10. Pearson correlation showed decreasing fractionation over time (r[1380] = -0.25; P < .01). Nearly 90% of patients lived within a 100-mile radius of the facility.
Conclusions:
Trends demonstrate stable patterns of use over time, despite the occurrence of global events such as the COVID-19 pandemic. Modern hypofractionation has driven steady decreases in fractionation, reducing travel burden and potential financial toxicity. Continued growth in the body of clinical evidence, paired with legislation and health policy supporting particle therapy, will allow further expansion and critical evaluation of PBT indications. Results demonstrate the feasibility and longevity of PBT in a community hospital setting.
