Background/Objectives:Proton therapy delivers highly conformal doses to the target area without producing an exit dose, minimizing cumulative doses to healthy liver tissue. This study aims to evaluate current practices, challenges, and variations in the implementation of proton stereotactic body radiation therapy (SBRT) and hypofractionated therapy for liver malignancies, with the goal of providing a technical assessment to promote broader adoption and support future clinical trials.Methods and Materials: An extensive survey was conducted by NRG Oncology across North American proton treatment centers to assess the current practices of proton liver SBRT and hypofractionated therapy. The survey focused on key aspects, including patient selection, prescription and normal tissue constraints, simulation and motion management, treatment planning, quality assurance (QA), treatment delivery, and the use of image-guided radiation therapy (IGRT).Results:This survey captures the current practice patterns and status of proton SBRT and hypofractionated therapy in liver cancer treatment. Proton therapy is increasingly preferred for treating inoperable liver malignancies due to its ability to minimize healthy tissue exposure. However, the precision required for proton therapy presents challenges, particularly in managing uncertainties and target motion during high-dose fractions and short treatment courses. Survey findings revealed significant variability in clinical practices across centers, highlighting differences in motion management, dose fractionation schedules, and QA protocols.Conclusion:Proton SBRT and hypofractionated therapy offer significant potential for treating liver malignancies. A comprehensive approach involving precise patient selection, treatment planning, and QA is essential for ensuring safety and effectiveness. This survey provides valuable insights into current practices and challenges, offering a foundation for technical recommendations to optimize the use of proton therapy and guide future clinical trials.
**背景/目的：** 质子治疗能够向靶区提供高度适形的剂量，且不产生出射剂量，从而最大限度地减少对健康肝组织的累积照射。本研究旨在评估当前针对肝脏恶性肿瘤实施质子立体定向体部放射治疗（SBRT）和大分割治疗的实践现状、面临的挑战及存在的差异，以提供技术评估，促进其更广泛的应用并为未来的临床试验提供支持。 **方法与材料：** NRG Oncology 对北美质子治疗中心开展了一项广泛调查，以评估当前质子肝脏 SBRT 和大分割治疗的实践情况。调查重点关注以下关键方面：患者选择、处方剂量与正常组织限制、模拟与运动管理、治疗计划、质量保证（QA）、治疗实施以及图像引导放射治疗（IGRT）的使用。 **结果：** 本次调查反映了质子 SBRT 和大分割治疗在肝癌治疗中的当前实践模式与现状。由于能够最大限度地减少对健康组织的照射，质子治疗在治疗不可手术的肝脏恶性肿瘤中日益受到青睐。然而，质子治疗所需的高精度也带来了挑战，尤其是在大剂量分割和短疗程治疗中管理不确定性和靶区运动方面。调查结果显示，各中心在临床实践中存在显著差异，尤其在运动管理、剂量分割方案和质量保证流程方面表现突出。 **结论：** 质子 SBRT 和大分割治疗在治疗肝脏恶性肿瘤方面具有重要潜力。为确保治疗的安全性和有效性，必须采取综合策略，包括精确的患者选择、治疗计划和质量保证。本次调查为当前实践与挑战提供了有价值的见解，并为优化质子治疗应用和指导未来临床试验的技术建议奠定了基础。
肿瘤(癌症)患者之家