Abstract：
OBJECTIVE: Radiotherapy with protons (PT) is a standard treatment of ocular tumors. It achieves excellent tumor control, limited toxicities, and the preservation of important functional outcomes, such as vision. Although PT may appear as one homogenous technique, it can be performed using dedicated ocular passive scattering PT or, increasingly, Pencil Beam Scanning (PBS), both with various degrees of patient-oriented customization.
UNASSIGNED: MEDICYC PT facility of Nice are detailed with respect to their technical, dosimetric, microdosimetric and radiobiological, patient and tumor-customization process of PT planning and delivery that are key. 6684 patients have been treated for ocular tumors (1991-2020). Machine characteristics (accelerator, beam line, beam monitoring) allow efficient proton extraction, high dose rate, sharp lateral and distal penumbrae, and limited stray radiation in comparison to beam energy reduction and subsequent straggling with high-energy PBS PT. Patient preparation before PT includes customized setup and image-guidance, CT-based planning, and ocular PT software modelling of the patient eye with integration of beam modifiers. Clinical reports have shown excellent tumor control rates (∼95%), vision preservation and limited toxicity rates (papillopathy, retinopathy, neovascular glaucoma, dry eye, madarosis, cataract).
RESULTS: Although demanding, dedicated ocular PT has proven its efficiency in achieving excellent tumor control, OAR sparing and patient radioprotection. It is therefore worth adaptations of the equipments and practice.
CONCLUSIONS: Some of these adaptations can be transferred to other PT centers and should be acknowledeged when using non-PT options.
UNASSIGNED: MEDICYC PT facility of Nice are detailed with respect to their technical, dosimetric, microdosimetric and radiobiological, patient and tumor-customization process of PT planning and delivery that are key. 6684 patients have been treated for ocular tumors (1991-2020). Machine characteristics (accelerator, beam line, beam monitoring) allow efficient proton extraction, high dose rate, sharp lateral and distal penumbrae, and limited stray radiation in comparison to beam energy reduction and subsequent straggling with high-energy PBS PT. Patient preparation before PT includes customized setup and image-guidance, CT-based planning, and ocular PT software modelling of the patient eye with integration of beam modifiers. Clinical reports have shown excellent tumor control rates (∼95%), vision preservation and limited toxicity rates (papillopathy, retinopathy, neovascular glaucoma, dry eye, madarosis, cataract).
RESULTS: Although demanding, dedicated ocular PT has proven its efficiency in achieving excellent tumor control, OAR sparing and patient radioprotection. It is therefore worth adaptations of the equipments and practice.
CONCLUSIONS: Some of these adaptations can be transferred to other PT centers and should be acknowledeged when using non-PT options.
摘要：
目的：质子放射治疗（PT）是眼部肿瘤的标准治疗方法。它实现了出色的肿瘤控制，有限的毒性，以及重要功能成果的保存，如视觉。虽然PT可能是一种同质技术，它可以使用专用的眼部被动散射PT或，越来越多,铅笔束扫描（PBS），两者都具有不同程度的面向患者的定制。
■尼斯的MEDICYCPT设施详细介绍了其技术，剂量测定,微剂量学和放射生物学，PT计划和交付的患者和肿瘤定制过程是关键。6684例患者接受了眼部肿瘤治疗（1991-2020年）。机器特性(加速器，束线,束监测)允许有效的质子提取，高剂量率，尖锐的外侧和远端半腰，与光束能量减少和随后的高能PBSPT散落相比，杂散辐射有限。PT前的患者准备包括定制设置和图像指导，基于CT的规划，和患者眼睛的眼部PT软件建模与光束修改器的集成。临床报告显示出优异的肿瘤控制率(~95%)，视力保护和有限的毒性率(乳头状病变，视网膜病变,新生血管性青光眼,干眼症,Madarosis,白内障)。
结果：虽然要求很高，专用眼PT已证明其在实现出色的肿瘤控制方面的效率，保护和患者辐射防护。因此，值得对设备和实践进行调整。
结论：其中一些适应可以转移到其他PT中心，在使用非PT选项时应予以承认。
■尼斯的MEDICYCPT设施详细介绍了其技术，剂量测定,微剂量学和放射生物学，PT计划和交付的患者和肿瘤定制过程是关键。6684例患者接受了眼部肿瘤治疗（1991-2020年）。机器特性(加速器，束线,束监测)允许有效的质子提取，高剂量率，尖锐的外侧和远端半腰，与光束能量减少和随后的高能PBSPT散落相比，杂散辐射有限。PT前的患者准备包括定制设置和图像指导，基于CT的规划，和患者眼睛的眼部PT软件建模与光束修改器的集成。临床报告显示出优异的肿瘤控制率(~95%)，视力保护和有限的毒性率(乳头状病变，视网膜病变,新生血管性青光眼,干眼症,Madarosis,白内障)。
结果：虽然要求很高，专用眼PT已证明其在实现出色的肿瘤控制方面的效率，保护和患者辐射防护。因此，值得对设备和实践进行调整。
结论：其中一些适应可以转移到其他PT中心，在使用非PT选项时应予以承认。
