There have been multiple warnings about range of uncertainty about Proton Therapy by a forum member who has had good results from CK or Cyber knife treatment. We discovered, in conversation with three doctors, all who have with excellent credentials, that image-guidance alleviates the range of uncertainty concerns. The three doctors who refuted the claim that Proton
Therapy involves range of uncertainty issues are :
1. Dr. Lilia N. Loredo, M.D. to The James M. Slater Proton Treatment and Research Center at Loma Linda University Medical Center (LLUMC),
LLUMC Radiation Medicine, Room B 113
11234 Anderson Street
Loma Linda, CA 92354
Attn: Carol Maas 909 558 8210
2. Dr. Jay Loeffler
100 Blossom Street
Boston, MA 02114
3. Dr. Allan F Thornton MD, 40 Enterprise Pkwy, Hampton, VA 23666
Phone: (877) 251-6838
Because I believe it is not permitted to post websites here. I urge the newly diagnosed to do an online search on the following words:
1. “…Reducing the uncertainties through image-guidance, adaptive radiotherapy, further study of biological properties of protons and the development of novel dose computation and optimization methods….”
Side comment from us: We believe that Dr. Loeffler’s staff seems to be an expert of reducing uncertainties through image-guidance.
2. Bull Cancer. 2018 Feb 5. pii: S0007-4551(18)30001-8. doi: 10.1016/j.bulcan.2017.12.004. [Epub ahead of print] [Why proton therapy? And how?] “…Proton therapy is a radiotherapy, based on the use of protons, charged subatomic particles that stop at a given depth depending on their initial energy (pristine Bragg peak), avoiding any output beam, unlike the photons used in most of the other modalities of radiotherapy…”
3. "Aug 22, 2012 Will protons gradually replace photons?"
4. "Should Randomized Clinical Trials Be Required for Proton Radiotherapy? Quote… Of course, it is really all about money. Can anyone seriously believe that, if protons were cheaper that x-rays, there would be similar objections raised as to their immediate and widespread use? "
Side comment: 2008 discussion about ethics
4. Small Monte Carlos sample- about new Pencil BEAM-from 2010. “…We have thus confirmed that our current planning and delivery process for small proton fields is accurate enough to treat small lesions in the patient. Furthermore, we studied the impact of field size corrections and identified limitations of the pencil beam algorithm for predicting hot and cold spots and range degradation in the target due scattering in heterogeneities…”
5. 2012 Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. email@example.com
On the subject of Range Uncertainty: “…The results of our study allow a quantitative consideration of RBE-caused range uncertainties as a function of treatment site and dose in treatment planning.”
6. "Department of Radiation Oncology, Francis H. Burr Proton Therapy Center Massachusetts General Hospital, Boston, Massachusetts 02114, USA. firstname.lastname@example.org Quote: ‘…Our improved understanding of the passive scattering mode of the IBA universal nozzle, especially of the current modulation function, allowed us to re-commission our treatment control system for accurate delivery of SOBPs of any range and modulation, and to predict the output for each of these fields. We moved away from individual field calibrations to a state where continued quality assurance of SOBP field delivery is ensured by limited system-wide measurements that only require one hour per week. This manuscript reports on a protocol for generation of desired SOBPs and prediction of dose output.”
7. "Proton Therapy highly conformal treatment "