The evolution of arc therapy with protons
Over the past decades, significant advances have been made in radiotherapy and proton therapy, including progress in treatment planning systems, quality of beam delivery, improved dose distributions and conformity, and improved target volume definition and delineation accuracy.
One of the most recent advances is the development of arc therapy, in which radiation is delivered by continuously rotating the radiation source. This allows the cancer patient to be treated with continuous beam delivery as the gantry rotates.
In proton therapy, the use of arc therapy with protons was suggested for the first time in 1997.1 The first in-silico study showing the potential of proton arc therapy to improve dose conformity was published in 2013.2 Then, in 2016, Ding et al. described the first proton spot-scanning arc optimization method compatible with existing proton therapy systems, using a ProteusONE system.3 Two years later, in 2018, IBA in partnership with Corewell Health (formerly William Beaumont Hospital) successfully performed the first prototype of dynamic proton arc delivery on a Proteus proton therapy system.4
IBA and its clinical, industrial and research partners aim to revolutionize cancer care by developing the first spot-scanning proton arc method, DynamicARC, using the ProteusONE system.
Discover the complete history of Arc Therapy by downloading the DynamicARC® Solution Paper:
The promise of DynamicARC
DynamicARC is expected to potentially be a novel and innovative treatment approach allowing simultaneous dynamic beam delivery at variable energies while the gantry is rotating.
Intensity Modulated Proton Therapy (IMPT) is now the current clinical practice where treatment is delivered in 2-3 static fields; however, DynamicARC helps target the tumor from an increased number of directions, enhancing tumor coverage and healthy tissue sparing.
IBA is committed to making proton therapy accessible to all patients who could benefit from it, and DynamicARC is an important step on this journey.
Delivering sharper, faster and simpler treatment
DynamicARC has the potential to significantly improve treatment delivery, allowing sharper, faster and simpler treatment.
- Sharper
DynamicARC could make treatment sharper by delivering an expected
lower integral dose and offering better dose conformity. This new modality may increase by 22% the number of patients eligible for proton therapy.5,6
- Faster
With an optimized workflow, DynamicARC can be faster than IMPT, allowing for higher patient throughput. Reductions of 58% of the average treatment delivery time per patient were estimated, and up to 30% increase in patient throughput compared to IMPT.7
- Simpler
DynamicARC is simpler than IMPT, avoiding complex beam arrangements, with fewer therapist actions such as couch rotations or accessory insertions between fields, simplifying treatment planning and delivery.
Discover the promise and advantages of DynamicARC by downloading the DynamicARC® Solution Paper:
Clinical indications for DynamicARC
DynamicARC is expected to benefit a wide range of clinical indications.
Over 150 patient cases** across 10 clinical studies have already compared plans with DynamicARC on ProteusONE with other treatment modalities. DynamicARC has shown encouraging results in brain cancer, head and neck cancer, breast cancer, lung cancer, prostate cancer and spine metastases, among others.
Among them, DynamicARC has shown the potential to significantly reduce the dose delivered to organs at risk across several indications. It also greatly simplifies workflow, may reduces toxicities, further improves the target coverage conformity and robustness, adds flexibility to achieve a more favorable linear energy transfer distribution with high LET inside the target, and better adapts to patient conditions and clinical resources available.8-15
DynamicARC may benefit a wide range of cancer types
Download the DynamicARC® Solution Paper and discover the published results of using DynamicARC across indications:
Notes
* DynamicARC is the registered brand of IBA’s Proton Arc therapy solution which is currently under research and development. DynamicARC will be available for sale when regulatory clearance is received. Due to a continuous research and development program, IBA reserves the right to make changes in design, technical descriptions, and specifications of its products without prior notice. Some features are under development and may be subject to review by competent authorities.
** As of September 2023
References
- Deasy JO et al. “Comformal Proton Tomotherapy Using Distaledge Tracking.” Radiotherapy and Oncology 37 (1995): S43.
- Seco J et al. “Proton Arc Reduces Range Uncertainty Effects and Improves Conformality Compared with Photon Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Non-Small Cell Lung Cancer.” International Journal of Radiation Oncology Biology Physics 87, no. 1 (2013): 188–94.
- Ding X et al. “Spot-Scanning Proton Arc (SPArc) Therapy – The First Robust and Delivery-Efficient Spot-Scanning Arc Therapy.” International Journal of Radiation Oncology • Biology • Physics 0, no. 0 (2016): 1107–16.
- Li X et al. “The First Prototype of Spot-Scanning Proton Arc Treatment Delivery.” Radiotherapy and Oncology 137 (2019): 130–36.
- de Jong B et al. Proton arc therapy increases the benefit of proton therapy for oropharyngeal cancer patients in the model-based clinic. Radiother Oncol. 2023:184;109670.
- de Jong B et al. Spot scanning proton arc therapy reduces toxicity in oropharyngeal cancer patients. Med Phys. 2023;50(3):1305-1317.
- Liu G et al. Development of a standalone delivery sequence model for proton arc therapy. Med Phys. 2023. doi: 10.1002/mp.16879.
- Ding X et al. Improving dosimetric outcome for hippocampus and cochlea sparing whole brain radiotherapy using spot-scanning proton arc therapy. Acta Oncol. 2019;58(4):483-490.
- Chang S et al. Redefine the Role of Spot-Scanning Proton Beam Therapy for the Single Brain Metastasis Stereotactic Radiosurgery. Front Oncol. 2022;12:804036.
- Chang S et al. Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy. Radiat Oncol. 2020;15:232.
- Liu G et al. Improve the dosimetric outcome in bilateral head and neck cancer (HNC) treatment using spot-scanning proton arc (SPArc) therapy: a feasibility study. Radiat Oncol. 2020;15(1):21.
- Ding X et al. Have we reached proton beam therapy dosimetric limitations? - A novel robust, delivery-efficient and continuous spot-scanning proton arc (SPArc) therapy is to improve the dosimetric outcome in treating prostate cancer. Acta Oncol. 2018;57(3):435-437.
- Liu G et al. Is proton beam therapy ready for single fraction spine SBRS? - a feasibility study to use spot-scanning proton arc (SPArc) therapy to improve the robustness and dosimetric plan quality. Acta Oncol. 2021;60(5):653-657.
- Li X et al. Linear Energy Transfer Incorporated Spot-Scanning Proton Arc Therapy Optimization: A Feasibility Study. Front Oncol. 2021;11:698537.
- Wuyckens S et al. Bi-criteria Pareto optimization to balance irradiation time and dosimetric objectives in proton arc therapy. Phys Med Biol. 2022;67(24).