{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T01:35:28Z","timestamp":1774488928411,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Medical Radiation Sci"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Proton beam therapy (PBT) is increasingly used to treat cancers, especially in the paediatric and adolescent and young adult (AYA) population. As PBT becomes more accessible, determining when PBT should be used instead of photon irradiation can be difficult. There is a need to balance patient, tumour and treatment factors when making this decision. Comparing the dosimetry between these two modalities plays an important role in this process. PBT can reduce low to intermediate doses to organs at risk (OAR), but photon irradiation has its dosimetric advantages. We present two cases with brain tumours, one paediatric and one AYA, in which treatment plan comparison between photons and protons showed dosimetric advantages of photon irradiation. The first case was an 18\u2010month\u2010old child diagnosed with posterior fossa ependymoma requiring adjuvant radiotherapy. Photon irradiation using volumetric modulated arc therapy (VMAT) had lower doses to the hippocampi but higher doses to the pituitary gland. The second case was a 21\u2010year\u2010old with an optic pathway glioma. There was better sparing of the critical optic structures and pituitary gland using fractionated stereotactic radiation therapy over PBT. The dosimetric advantages of photon irradiation over PBT have been demonstrated in these cases. This highlights the role of proton\u2010to\u2010photon comparative treatment planning to better understand which patients might benefit from photon irradiation versus PBT.<\/jats:p>","DOI":"10.1002\/jmrs.773","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T07:20:00Z","timestamp":1710919200000},"page":"90-98","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Is proton beam therapy always better than photon irradiation? Lessons from two cases"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-1090","authenticated-orcid":false,"given":"Michelle P","family":"Li","sequence":"first","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9725-0668","authenticated-orcid":false,"given":"Adam","family":"Yeo","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia"},{"name":"School of Applied Science RMIT University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roshini","family":"Gunewardena","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Drum","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsty","family":"Wiltshire","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Phillips","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Sia","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Hall","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000724"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmrs.454"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1754-9485.12391"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1754-9485.13510"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canrad.2011.04.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","DOI":"10.1259\/bjr.20180004","article-title":"Proton relative biological effectiveness (RBE): A multiscale problem","volume":"92","author":"Underwood TS","year":"2019","journal-title":"Br J Radiol"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/sup.2006.105.7.194"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v15i6.4978"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nox166"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2021.01.027"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab301"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/not121"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2016.06.292"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noz068"},{"key":"e_1_2_10_16_1","unstructured":"KahalleyL HindsP MabbottD.Comparison of Symptom Burden\/Toxicity Neurocognitive Change and Functional Outcomes in Pediatric Brain Tumor Patients Treated with Proton vs. Photon Radiotherapy: Mabbott Lab. 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Available from:https:\/\/lab.research.sickkids.ca\/mabbott\/2022\/03\/02\/pxcog\/."},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8122153"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.14791\/btrt.2022.0003"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2019.01.078"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2043515"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmrs.615"},{"issue":"12","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"S174","DOI":"10.4103\/0028-3886.373636","article-title":"Proton radiosurgery: Current concepts and limitations for CNS radiosurgery","volume":"71","author":"La Rosa A","year":"2023","journal-title":"Neurol India"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2015.00261"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2023.101273"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmrs.721"}],"container-title":["Journal of Medical Radiation Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmrs.773","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T17:36:37Z","timestamp":1731605797000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmrs.773"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,20]]},"references-count":24,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/jmrs.773"],"URL":"https:\/\/doi.org\/10.1002\/jmrs.773","archive":["Portico"],"relation":{},"ISSN":["2051-3895","2051-3909"],"issn-type":[{"value":"2051-3895","type":"print"},{"value":"2051-3909","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,20]]},"assertion":[{"value":"2023-08-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}