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The potential advantages and drawbacks of pencil beam scanning proton therapy in the management of paediatric, teenage and young adult malignancies

Lim, Pei Shuen; (2021) The potential advantages and drawbacks of pencil beam scanning proton therapy in the management of paediatric, teenage and young adult malignancies. Doctoral thesis (M.D(Res)), UCL (University College London). Green open access

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Abstract

Pencil beam scanning (PBS) proton therapy is a new radiation modality which is increasingly used for childhood teenage and young adult malignancies due to its ability to minimise dose to surrounding organs, which in turn translates to reduced late toxicity. However, its dosimetry is extremely sensitive to anatomical changes, density changes and motion. Research on its benefits, drawbacks, clinical efficacy and side effects is therefore required for clinical teams to understand the best way and situation to use this modality in the clinic. Neuroblastoma is a childhood cancer most commonly arising within the abdomen. Radiotherapy to the primary tumour bed is part of the multimodality management for high risk patients. This collection of work investigates the benefits and detriments of PBS in abdominal neuroblastoma alongside the associated dosimetric impact from uncertainties such as set up variation, gastrointestinal tract density variability and intra-field motion. Methods of managing the uncertainties are also examined. Teenage and young adults are a unique and challenging group of patients with complex psychosocial needs. The efficacy and late effects of PBS in this age group with brain and skull base tumours is detailed with analysis of their employment status during survivorship.

Type: Thesis (Doctoral)
Qualification: M.D(Res)
Title: The potential advantages and drawbacks of pencil beam scanning proton therapy in the management of paediatric, teenage and young adult malignancies
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10122903
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