PTCOG Ocular Survey – Perspective on Ocular Particle Therapy: Current Practices and Emerging Trends
International Journal of Particle Therapy, vol. 19, pp. 101300
Abstract
Purpose: To overview the status and trends in the current rapidly evolving field of ocular particle therapy (OPT). Materials and Methods: The Particle Therapy Co-Operative Group Ocular Subcommittee developed an online survey, including 127 questions, made available to treatment centers worldwide, between April 2022 and January 2024. The survey covered a broad range of topics from general program organization and beamline description, to diagnoses and patient numbers treated, treatment planning and set-up, quality assurance techniques, as well as insights into anticipated future developments. Results: Twenty facilities offered OPT by the end of 2023: 3 in Asia, 9 in Europe, and 8 in the USA. Combined, they treated, on average, 1800 patients per year, with uveal melanoma being the most common indication. The vast majority of treatments continue to be delivered on dedicated horizontal beamlines, both high (>120 Mev) and low (<75 MeV) energy. Five of the 7 recently established programs (n = 7, since 2015) use high-energy general-purpose beamlines, where some beam characteristics, including penumbrae size and dose delivery rate, differ from those typically achieved on dedicated beamlines. The evolution of the ocular treatment framework is ongoing as 9 centers reported the intent to upgrade their systems within five years, to engage state-of-the-art developments in beam delivery, imaging, and planning tools. Conclusion: Common protocols in dosimetry, dose, and fractionation have largely been adopted worldwide, while variability persists in planning, quality assurance, and delivery workflows. The obsolescence of dedicated ocular proton systems and key planning tools, and a lack of standardization, remain as pressing challenges. The adoption of non-dedicated high-energy systems on gantries and integration into multipurpose treatment environments enhances OPT accessibility, but this transition requires ongoing critical evaluation of dosimetric trade-offs and clinical outcomes. Multicenter collaboration, technological innovation, and clinical validation are essential to continued assurance of the safe and effective delivery of OPT worldwide.
Authors 18
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Linda Mortimer corresponding
Clatterbridge Cancer Centre NHS Foundation Trust
Affiliation as printed
Medical Physics Department, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
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Affiliation as printed
Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA
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IDCQ Hospitales y Sanidad, S.L.U.
Affiliation as printed
Centro de Protonterapia Quironsalud, Madrid, Spain
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Jan-Willem M. Beenakker Aachen
Leiden University Medical Center · Holland Particle Therapy Center
Affiliation as printed
HollandPTC, Delft, the Netherlands
Leiden University Medical Center, Departments of Ophthalmology, Radiology and Radiation Oncology, Leiden, the Netherlands
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Affiliation as printed
Institut Curie Proton Therapy Center, Building 101, Orsay University Campus, Orsay, France
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Helmholtz-Zentrum Berlin für Materialien und Energie
Affiliation as printed
Helmholtz-Zentrum Berlin für Materialien und Energie, Protonentherapie, Berlin, Germany
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Erasmus MC · Erasmus MC Cancer Institute · Holland Particle Therapy Center
Affiliation as printed
Erasmus Medical Center Cancer Institute, University Medical Center, Department of Radiotherapy, Rotterdam, the Netherlands
HollandPTC, Delft, the Netherlands
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Affiliation as printed
Centre Antoine Lacassagne, Nice, France
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Affiliation as printed
Department of Medical Physics and Biomedical Engineering, University College London, UK
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University of California, San Francisco
Affiliation as printed
Department of Radiation Oncology, University of California, San Francisco, CA, USA
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Affiliation as printed
Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA
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Massachusetts General Hospital · Mass General Brigham
Affiliation as printed
Department of Radiation Oncology, Massachusetts General Hospital/Mass General Brigham, Boston, MA, USA
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Centre National de la Recherche Scientifique · École Nationale Supérieure d'Ingénieurs de Caen · Laboratoire de Physique Corpusculaire de Caen · Centre François Baclesse · Institut National de Physique Nucléaire et de Physique des Particules · Université de Caen Normandie
Affiliation as printed
Centre François Baclesse, Caen, France
Université de Caen Normandie, ENSICAEN, CNRS/IN2P3, LPC Caen UMR6534, Caen F-14000, France
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Czech Technical University in Prague
Affiliation as printed
Faculty of Nuclear Sciences and Physical Engineering, Czech Technical University in Prague, Prague, Czech Republic
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Affiliation as printed
Centre Antoine Lacassagne, Nice, France
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Harvard University · Massachusetts General Hospital · Mass General Brigham
Affiliation as printed
Department of Radiation Oncology, Massachusetts General Hospital/Mass General Brigham, Boston, MA, USA
Harvard Medical School, Boston, MA USA
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Affiliation as printed
Paul Scherrer Institut, PSI, Forschungsstrasse, Villigen, Switzerland
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Helmholtz-Zentrum Berlin für Materialien und Energie · Charité - Universitätsmedizin Berlin
Affiliation as printed
Charité - Universitätsmedizin Berlin, Department of Ophthalmology and Berlin Protonen at HZB, Berlin, Germany
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