Protons are the dominant baryonic particle in the universe, comprising 87% of particle mass. Protons have a positive charge and are present in every atom, participating in all matter interactions. Proton therapy delivers a high radiation dose localized to the tumor site using proton beams, which deposit more energy at the tumor compared to X-rays due to the Bragg peak effect, sparing surrounding healthy tissues. Clinical applications of proton therapy include treatment of ocular melanoma, skull base and spine sarcomas, optic pathway gliomas, astrocytomas, and meningiomas.

2. Big Bang Theory: hydrogen was the first
element to form in the universe
13.7 billion years ago??
Proton is the nuclei of hydrogen.
Protons are the dominant baryonic
subatomic particle in the visible universe,
comprising ≈87% of the particle mass. They
are present in each atom of our universe
and thus a participant in every activity
involving matter.

4. Proton
Neutron
Electron
Proton has positive charge (1.6 × 10-19 Coulombs)
mass of 1.6 × 10-27 kg (~1,840 times the mass
of electron).
Atom
Nucleus

5. Proton is positive charged
particle in side the nuclei, proton
consist of three of 3 quarks two
up and one down) held together
Gluons

6. The proton is the most stable particle half-life of >1032 years)
And decays into particles:-

7. Proton interactions
Coulomb force with
atomic electrons
ionization and
excitation
Elastic Nuclear multiple
scatter
Non elastic nuclear
Interactions

8. +
P +
Elastic g coulomb scattering of the proton
With nucleus
Non elastic nuclear proton interaction
Recoil nucleus
a,B .Y rays

9. Proton beam
Proton beam therapy delivers
a high dose of radiation to a very
localized site. Protons, unlike x-rays,
decelerate faster than photons.
They deposit more energy as
they slow down, culminating in
X ray a peak – known as the Bragg peak
the energy loss of the particles per depth
called stop power. the LET of proton
is more higher then x ray &damage
to tissue for proton radiation (bragg peak
than spread x ray

10. 0 5
10 15
50
%
.
100
%
%depth dose
Depth in cms
Pragg peak Compare with x ray curve
Area of normal tissues not given radiation by proton
tumor

11. 60%
20%
80%
Dose distribution compering proton beam & x ray
5 cms
10 cms
15 cms
5 cms
10 cms
15 cms
100%
Proton X ray

12. Proton beam is generated by accelerated of proton beam to
high energy by :-

14. a synchrotron diagram

16. the Bragg peak of a mono energetic proton beam is too narrow
to cover the extent of most target volumes in order to provide
wider depth coverage, this 3 techniques are used clinically:
Techniques

17. These techniques are used to broaden the narrow proton beam created by
the accelerator into one that can achieve a uniform dose coverage of the
target at all depth

18.  The national of use proton therapy
Give high dose with out affecting surrounding normal tissues So can
be used to radio-resistant tumors
Saving the surrounding serous organs so used in brain tumors
Avoiding radiotherapy toxicity as in pediatrics tumors and
recurrences tumors (head and neck cancer)
The rational of use proton therapy

19. Ocular melanoma:-
 the near by structures very serious organs (lens, retina, fovea
and optic nerve). with uveal melanoma had been treated with
protons at Massachusetts, The 5-year local control rate was 96%
for all sites within the globe, with an 80% survival rate. The
probability of eye retention at 5 years was estimated to be 90%
for the entire group and 97%, 93%, and 78% for patients with
small, intermediate, and large tumors.
 Egger and colleagues11 reported long-term results of eye
retention after treatment of uveal melanoma with proton The
overall eye retention rate at 5, 10, and 15 years after treatment
was 89%, 86%, and 83%
Clinical applications of proton

20. Sarcomas of the Skull Base and Spine:
proximity of critical structures, notably, the brain, brainstem,
cervical cord, optic nerves, and chiasm. Accordingly, surgery and
conventional photon.
 Massachusetts General Hospital, physicians used a combination
of protons and photons to treated 169 patients of chondroma
and 165 of chondrosarcomas The 10-year local control rate was
highest for chondrosarcomas, intermediate for male
chordomas, and lowest for female chordomas (94%, 65%, and
42%, respectively)

21. Optic Pathway Glioma:
At loma linda University, 7 children up of 37 months all were
locally control. When compare the to photon beam these was
47% reduction in dose to contralateral optic nerve
Astrocytoma:
 Proton Therapy in Orsay, France, With a median follow-up
 of 18 months, local control rates were 97%

22.  Benign Meningioma:
Between 1981 and 1996, 46 patients with partially resected,
biopsied, or recurrent benign meningiomas were treated with
 combined proton/photon radiation at Harvard Laboratory
/Massachusetts Hospital. Overall survival rates at 5 and 10 years
were 93% and 77%, respectively, and recurrence-free rates at 5
and 10 years were 100% and 88%, respectively. Three patients
presented with local tumor recurrence at 61, 95, and 125 months.
One patient died of focal brain necrosis at 22 months

23. Proton therapy used in many
other cancer include
medulloblastoma in children
Head and neck and recurrences
in different organs

24. Historical photos of the Beja tribes in eastern Sudan