OncoLink Proton Education Modules

Module 1: An Introduction to Proton Therapy Robert Wilson first proposed the use of protons for the treatment of cancer in a scientific article in 1946. He recognized the importance of highly localized deposition of energy as a way of increasing the dose to the tumor while minimizing the dose...
Module 2: The Physics of Proton Therapy Energy Loss of Charged Particles in Matter, the Bragg Peak, Distal Fall off and Range Uncertainties One of the major advantages protons have over photons is the lack of exit dose. Shown below is a graph depicting the relative dose deposited in...
Module 3: Equipment for proton therapy delivery Accelerators: Cyclotrons and Synchrotrons The first step in generating a proton beam is to obtain a source of protons which can then be accelerated to energies sufficient for treatment. This can be done using hydrogen as the starting product and...
Module 4: Radiobiology and Radiation Safety Radiobiology: Linear Energy Transfer (LET) and Relative Biological Effect (RBE) Radiation is generally measured in units of absorbed dose (gray or rads) which are defined as the amount of energy absorbed per unit mass of tissue. However, this value...
Module 5: Clinical Outcomes by Disease Site - The Use of Proton Therapy in the Treatment of Cancers and Benign Diseases of the Central Nervous System Benign Disease: Arteriovenous Malformations (AVM), Acoustic Neuromas (AN), and Meningiomas There are a number of benign diseases which can be treated with radiation. However, because these are benign diseases, the amount of toxicity which is...
Module 5: Clinical Outcomes by Disease Site - The Use of Proton Therapy in the Treatment of Cancers of the Connective Tissues and Bone Osteosarcomas Proton based therapy for sarcomas is being heavily investigated due to the need to both improve outcomes and decrease acute and late effects that may affect general and health-oriented quality of life. Several centers have published...
Module 5: Clinical Outcomes by Disease Site - The Use of Proton Therapy in the Treatment of Cancers of the Gastrointestinal System Cancers of the esophagus Esophageal cancer has historically been treated with a combination of surgery (when possible), photon radiotherapy, and chemotherapy. Radiation therapy doses to the esophagus are limited by nearby critical structures...
Module 5: Clinical Outcomes by Disease Site - The use of proton therapy in the treatment of cancers of the head and neck The morbidity associated with the treatment of head and neck cancer with protons and conventional photons has been reviewed at various institutions. Specifically, cancers of the paranasal sinuses, tonsillar region, and nasopharynx have been...
Module 5: Clinical Outcomes by Disease Site - The Use of Proton Therapy in the Treatment of Cancers of the Lung Lung-cancer is the most common malignancy seen in men and women in the United States. Lung cancer is responsible for more cancer deaths in the United States than any other cancer and an estimated 161,840 people will die of lung cancer in 2008. This...
Module 5: Clinical Outcomes by Disease Site - The Use of Proton Therapy in the Treatment of Cancers of the Prostate A significant proportion of patients treated in radiation oncology centers have prostate cancer. Side effects of treatment generally include gastrointestinal (GI) and genitourinary (GU) damage. Large numbers of patients experience urinary frequency...
Module 5: Clinical Outcomes by Disease Site - Tumor Control and Retreatment with Proton Therapy Tumor Control with Proton Therapy As more patients are treated with proton therapy, long term results on various sites of disease will be reported. When the same dose and fractionation regimens are used for X-rays and protons, there are similar cure...
Module 6: Simulation, Positioning, Verification and Immobilization Simulation Simulations for proton therapy are similar to photon-based simulations in that they are predominantly done using CT scanners at present. However, proton simulation does have a number of factors which require special consideration. Due to...
Module 7: Treatment Volumes and Treatment Planning in Proton Therapy Treatment Volume, Lateral and Distal Margins Much like photon based therapy, with proton based therapy a gross tumor volume (GTV) that encompasses all clinically demonstrable disease is defined during proton treatment planning. An expansion from...
Module 8: Pediatric Proton Therapy The treatment of childhood tumors is an area where proton therapy may significantly reduce the acute and long-term complications associated with conventional radiation therapy. Pediatric cancer treatment has significantly improved over the past few...