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Summary
protons offer both, a
superior dose distribution
and a
reduction
of the
integral dose
.
currently
no clear clinical evidence
that the RBE deviates
significantly from the value of 1.1
(clonogenic cell survival data !!!)
normal tissue damage
does not differ
from our conventional
radiation experience
(risk of hot spots in normal tissue after spot scanning)
scanning will most likely
increase the variation in LET
and thus
potentially the variation in RBE within an irradiated volume
recommodation for planning:
•
avoid beams pointing directly toward a
critical OAR structure
•
RBE adjustment
for low a/b tissues and for RBE toward the distal edge
Protons