Proton therapy (PT) is one of the latest advancements in the treatment modalities of cancers. PT is specifically used to treat HnN cancer patients due to its less toxic effects on the surrounding critical structures. Keeping in view the opportunities for further advancements, there has been quite a lot of literature covering PT in HnN cancer patients. However, there has not been a compiled study that compares the toxicities, overall survival (OS), local control (LC), and quality of life (QoL) of PT with that of IMRT. The objective of this review is to compile & summarize the literature available on the toxicities, OS, LC, and QoL in HnN cancer patients post-Proton therapy.

Background: Currently, many researchers focus their work on the effects of bionanoparticles inside the tumor during Proton therapy. Indeed, these bio-nanoparticles enhance the absorbed dose especially if they have been settled at the Bragg peak zone. The main goal of this study is to give a new technique that improves and facilitates the clinical protocol during Proton therapy for brain tumors by adding nanoparticles to the tumor and using a rotary accelerator with high energy (200 MeV). Materials and Methods: With the use of the Monte Carlo Geant4 code, we simulated a Proton therapy of a tumor located in the center of a human head containing bionanoparticles. The Proton beam energy was chosen large enough to avoid having Bragg's peak at head level. Results: The results revealed that there was an optimization in the deposited energy at the tumor, at the same time the deposited energy at healthy tissue was less compared to ordinary Proton therapy. It also showed that the platinum is the most effective bio-nanoparticles used in this work. Conclusion: The addition of bio-nanoparticles to tumors and the use of a high-energy (200 MeV) rotary accelerator improve and facilitate Proton therapy. This new technique allows the direction angle of the Proton beam to be changed regardless of the position of the tumor, making it effective against moving tumors and preserving healthy tissue. In addition, the dose deposited in the tumor can be increased just by pivoting the head of the accelerator around the organ.

One of the on-line range verification techniques in Proton therapy is time -of-flight (TOF) measurement for prompt gamma. In this technique, the prompt gamma timing spectra is measured using the time difference between passage of the particle bunch through the target entrance of the beam and the arrival time of the corresponding prompt γ-ray at the detector. In this study, homogeneous PMMA phantom and PMMA phantoms with a slice of bone or air cavity were simulated in GEANT4 simulation. These targets were irradiated with a Proton pencil beam with an initial energy of 150 MeV, and the resulting PGT spectra was recorded by scintillation detectors. Then, a code was programmed in MATLAB software to analytically solve the kinematics of Proton movement in the phantom, and the PGT spectrum obtained from GEANT4 was given as an input to this software code and the prompt gamma-ray emission profiles was obtained in the phantom. In this study, the effect of the type and position of the heterogeneous slice on the PGT spectrum and the prompt gamma-ray emission profiles resulting from the PGT transformation was investigated. From the comparison of the prompt gamma-ray emission profile resulting from PGT spectra conversion, with the energy deposition spectra resulting from GEANT4 simulation, it was observed that the range shift and the shift of energy deposition location resulting from an inhomogeneity in PMMA have a significant relationship compared to the reference phantom. The presence of an inhomogeneous slice of bone and air cavity with a thickness of 10 mm shifts the range of the Proton compared to its range in the reference phantom by 4 mm and 9.6 mm, respectively, and the spectra of energy deposition for these states are respectively 4.8 mm and 9.9 mm shifted relative to the energy deposition spectra of the reference phantom. Therefore, the PGT spectra reflects the Proton transit time in the target material and provides the possibility of determining the prompt gamma-ray emission profiles and the possibility of confirming the delivery of the dose to the patient's body.

Background: Beam therapy, the most common and successful treatment used after surgery, plays an important role in treating cancer. In Proton therapy, Proton beam (PB) particles irradiate the tumor. To enhance the treatment of breast tumors, gold nanoparticles (GNPS) can be injected into the tumor simultaneously as irradiating the PB. Methods: This paper aims to simulate the treatment of breast tumors by using PBs and injecting GNPs with different concentrations simultaneously. We introduced the breast phantom (BP), then we irradiated it with a Proton pencil beam, which is also injected with GNPs simultaneously. We used the GEANT4/ GATE7 (G4/G7) code to show the enhancement of the absorbed dose in the tumor. Results: The findings of our simulations show that the location of the Bragg peak within the tumor shifts to higher depths with increasing energy. Also, by injecting GNPs in different amounts of 10, 25, 50, and 75 mg/ml with simultaneous irradiation of the PB, the rate of absorbed dose increases up to 1. 75% compared to the non-injected state. Our results also show that the optimal range of Proton energy that creates the Bragg peaks within the tumor is between 28 to 35 MeV, which causes the spread out of the Bragg peak. It should be noted that the amount of absorbed dose is affected by quantities such as total stopping power, average Coulomb scattering angle, CSDA range, and straggling range. Conclusion: This work offers new insights based on the use of GNPS in the treatment of breast cancer through Proton therapy and indicates that adding GNPS is a promising strategy to increase the killing of cancer cells while irradiating fast PBs. In fact, the results of this study confirm the ability of GNPs to enhance treatment by increasing the absorbed dose in breast tumors using Proton therapy.

The application of radiation therapy (RT) in lung cancer has shown some exciting and sometimes disappointing advances in recent years. Protons compared with photons interact differently with human tissues, and can be used to improve patient care for suffering from lung cancer. A new strategy is the simultaneous injection of nanoparticles with Proton radiation into the tumor which has been given over a decade to improve conventional RT. In this work, Proton beam therapy (PBT) with gold nanoparticles (GNPs) is used as a part of a combination program to treat advanced localized lung cancers. This paper aims to develop the complex Geant4 model on the human lung and predict the distribution of absorbed dose in lung tumors during Proton therapy without and with a high-Z injection of GNPs. Thus, the absorbed dose distribution in lung tumors for four modes such as (i) Bethe-Bloch’, s relativistic quantum theory, (ii) GEANT4/ GATE7 simulation model, (iii) Hartree-Fock-Roothaan(HFR) wave functions, and the (vi) Bortfeld theoretical model without and with the injection of GNPs in predicted lung phantom are compared.

In this study, a Compton camera imaging system containing several scatterer layers made of Si and a LYSO detector as an absorber layer were designed and simulated using Geant4 code. At first, the efficiency of the system according to the number of scatterer layers was optimized using a gamma point source with various energies. After finding the best structure of the system which contains 10 layers of scatterer, two similar setup of Compton camera were placed perpendicularly to the Proton beam around the phantom to take image of the position of the prompt gamma emission resulted from the nuclear interaction of the Proton beam with the phantom. In order to imaging the gammas, information such as interaction positions and deposited energies in the scatterers and absorber were recorded by Geant4 code in a root file. Then, using a Compton camera reconstruction algorithm, production position profile of gammas was reconstructed in a MATLAB software. A Comparison of the gamma photon distribution and dose distribution showes that this Compton camera structure is able to measure the Proton beam range with less than 7 mm error, which proves the capability of prompt gammas detection for verification of the Proton beam range during Proton therapy.