title: Comparative planning study for proton radiotherapy of benign brain tumors.
abstract: OBJECTIVE
  A comparative study of different systems for proton-based radiotherapy was conducted.
  
  
  METHODS
  The Paul Scherrer Institute method for spot scanning was compared with the systems for passive scattering from the Helax-TMS and the Varian Eclipse. Twelve cases of "benign" brain tumors were considered (meningiomas, neurinomas, and hypophyseal adenomas). Organs at risk included chiasm, brainstem, eyes and optic nerves as well as the not otherwise specified healthy brain tissue in view of long-term toxicity.
  
  
  RESULTS
  The results showed that high target coverage was achievable (V(90) > 98% for all systems). Plans designed with the spot-scanning technique presented the minimum involvement of healthy tissue (e. g., the lowest maximum significant dose to healthy brain [25.6 Gy] or the lowest conformity index [CI(95) = 1.3], between 38% and 46% lower than for the other techniques).
  
  
  CONCLUSIONS
  In this study, no definitive indication of superiority of any technique can be drawn but spot scanning can better conform dose distributions and minimize the irradiation of healthy volumes at medium to low dose levels, a factor of interest when long life expectancy is considered.
authors.affiliation: Medical Physics, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. lucozzi@iosi.ch
authors.forename: Luca
authors.initials: L
authors.lastname: Cozzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Clivio
authors.forename: Eugenio
authors.initials: E
authors.lastname: Vanetti
authors.forename: Giorgia
authors.initials: G
authors.lastname: Nicolini
authors.forename: Antonella
authors.initials: A
authors.lastname: Fogliata
mesh_terms: D000236:Adenoma / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008579:Meningioma / Q000532:radiotherapy; D008875:Middle Aged; D009442:Neurilemmoma / Q000532:radiotherapy; D061766:Proton Therapy; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D011522:Protons
chemical_list: D011522:Protons