JRSBRT 9.1, p. 7-8

Debate 2: For Photon SBRT
Are we ready for the SBRT option using proton beams?
Kristin A. Higgins and Fang-Fang Yin

Stereotactic body radiation therapy (SBRT) has widely been adapted as an effective and efficient radiation therapy option for a certain group of patients as it delivers higher dose per fraction with conformal dose distributions [1]. This treatment option requires high treatment accuracy and precision, especially for lung and liver tumors where both organ motion and tissue inhomogeneity could introduce substantial dosimetric uncertainty. At present, photon beams are the modality of choice for SBRT as the positive clinical outcomes for both lung and liver cancers are extensively reported during the last two decades [2-4]. Technical procedures for patient immobilization, simulation imaging, treatment planning, image-guidance in the treatment room and delivery are well established [1] along with the development of many motion management techniques. Recently, proton radiation therapy utilization has grown, due to its dose deposit characteristics that allow higher conformal dosimetry to the target with much less dose to the normal structures compared to conventional photon beams, as well as increased number of centers that offer proton therapy [5]. Interest in using proton or other types of heavier particle beams for SBRT are emerging as a potential treatment option as more centers have access to these technologies.

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