Presented by David Alicia, CMD
Senior Medical Dosimetrist
Maryland Proton Treatment Center

Lung tumors are arguably one of the most complex sites of interest for proton planning. In re-treat scenarios for lungs, we often find ourselves planning for photon and proton simultaneously because we aren’t quite sure which modality will hold up more robustly during the patient’s course of treatment. Although protons have a much better job at reducing integral and low dose to the OARs within the lung region, the photon plan can do a better job in maintaining coverage to the target of interest. In this presentation, we will discuss five cases in which both proton and photon plans were evaluated. Some of the cases include both proton and photons that have been treated, QACTs that have shown that photon plans are more superior, and QACTs that have shown that proton plans are more superior. With these five cases, we will discuss what factors of the treatment planning process in each modality made them advantageous and as well as which particular type of lung tumors are better suited for proton plans over photon plans and vice versa. We will go over beam arrangements in proton and photon plans, tumor subtypes, robust parameters in protons, and major difference in OARs dose levels.

Learner Outcomes:

1. Review basic concepts of proton planning and the advantages it had in lung planning over photon planning.
2. Making connections with different subtypes and modalities (proton vs photon) that are more effective in treating those subtypes.
3. Understanding the effects of tumor change on both processes

Presenter:
David Alicia, CMD,  is a senior medical dosimetrist at the Maryland Proton Treatment Center, affiliated with the University of Maryland Medical Center. He has developed extensive experience in both proton and photon planning. He is also one of the many instructors at the Dosimetry School held at the University of Maryland. Mr. Alicia has graduated from Stony Brook University's Medical Dosimetry Program in 2017. He has worked with the University of Maryland Medical center for 4 years now.

Educational Level: Entry Level

ARRT CQR Credit Distribution
Proton Therapy (PTH- 2019)
Procedures        
    Treatments = 1.00 credit

Radiation Therapy (THR – 2017)
Procedures        
    Treatments = 1.00 credit

Radiation Therapy (THR – 2022)
Procedures        
    Treatments = 1.00 credits