Proton therapy has gained popularity for its ability to precisely deposit energy at a specific depth, allowing for higher tumor doses while minimizing radiation exposure to surrounding healthy tissue. This advantage is particularly relevant for head and neck squamous cell carcinoma (HNSCC), the seventh most common cancer globally, where radiotherapy is challenging due to the tumor’s location near critical organs. Despite advances in conventional photon-based radiotherapy, treatments still expose nearby critical organs, often resulting in severe side effects that significantly impact patients’ quality of life. However, robust clinical evidence supporting the superiority of proton therapy for HNSCC remains limited, partly due to the tumor’s heterogeneity and variations in treatment response driven by intrinsic biological factors and the tumor microenvironment. Furthermore, differences in energy deposition at the molecular level between protons and photons may influence DNA repair mechanisms, potentially affecting treatment efficacy in tumors with DNA repair deficiencies. Understanding these variations in biological effects is essential for improving HNSCC patient selection for proton and photon therapy and optimizing personalized radiotherapy strategies....

HollandPTC is an independent outpatient center for proton therapy, scientific research, and education. Patients with different types of cancer are treated with Intensity Modulated Proton Therapy (IMPT). Additionally, the HollandPTC R&D consortium conducts scientific research into the added value and improvements of proton therapy. To this end, HollandPTC created clinical and pre-clinical research facilities including a versatile R&D proton beamline for various types of biologically and technologically oriented research. In this work, we present the characterization of the R&D proton beamline of HollandPTC. Its pencil beam mimics the one used for clinical IMPT, with energy ranging from 70 up to 240 MeV, which has been characterized in terms of shape, size, and intensity. For experiments that need a uniform field in depth and lateral directions, a dual ring passive scattering system has been designed, built, and characterized. With this system, field sizes between 2 × 2 cm² and 20 × 20 cm² with 98 % uniformity are produced with dose rates ranging from 0.5 Gy/min up to 9 Gy/min. The unique and customized support of the dual ring system allows switching between a pencil beam and a large field in a very simple and fast way, making the HollandPTC R&D proton beam able to support a wide range of different applications.

Background and purpose:
Understanding the cellular and molecular effect of proton radiation, particularly the increased DNA damage complexity at the distal end of the Bragg curve, is current topic of investigation. This work aims to study in vitro clonogenic survival and DNA damage foci kinetics of a head and neck squamous cell carcinoma cell line at various positions along a double passively scattered Bragg curve. Complementary in silico studies are conducted to gain insights into the link between cell survival variations, experimentally yielded foci and the number and complexity of double strand breaks (DSBs).

Materials and methods:
Proton irradiations are performed at the HollandPTC R&D proton beamline, using a double passively scattered setup. A custom water phantom setup is employed to accurately position the samples within the Bragg curve. FaDu cells are irradiated at the proximal 36 % point of the Bragg peak, (P36), proximal 80 % point of the Bragg peak (P80) and distal 20 % point of the Bragg peak (D20), with dose-averaged mean lineal energies (yD¯) of 1.10 keV/μm, 1.80 keV/μm and 7.25 keV/μm, respectively.

Results:
Clonogenic survival correlates strongly with yD¯, showing similar survival for P36 (D37%=3.0 Gy) and P80 (D37%=2.9 Gy), but decreased survival for D20 (D37% = 1.6 Gy). D20 irradiated samples exhibit increased 53BP1 foci shortly after irradiation, slower resolution of the foci, and larger residual 53BP1 foci after 24 h, indicating unrepaired complex breaks. These experimental observations are supported by the in silico study which demonstrates that irradiation at D20 leads to a 1.7-fold increase in complex DSBs with respect to the total number of strand breaks compared to P36 and P80.

Conclusions:
This combined approach provides valuable insights into the cellular and molecular effect of proton radiation, emphasizing the increased DNA damage complexity at the distal end of the Bragg curve, and has the potential to enhance the efficacy of proton therapy.

A Geant4 based simulation platform of the Holland Proton Therapy Centre (HollandPTC, Netherlands) R&D beamline (G4HPTC-R&D) was developed to enable the planning, optimisation and advanced dosimetry for radiobiological studies. It implemented a six parameter non-symmetrical Gaussian pencil beam surrogate model to simulate the R&D beamline in both a pencil beam and passively scattered field configuration. Three different experimental proton datasets (70 MeV, 150 MeV, and 240 MeV) of the pencil beam envelope evolution in free air and depth-dose profiles in water were used to develop a set of individual parameter surrogate functions to enable the modelling of the non-symmetrical Gaussian pencil beam properties with only the ProBeam isochronous cyclotron mean extraction proton energy as input. This refined beam model was then benchmarked with respect to three independent experimental datasets of the R&D beamline operating in both a pencil beam configuration at 120 and 200 MeV, and passively scattered field configuration at 150 MeV. It was shown that the G4HPTC-R&D simulation platform can reproduce the pencil beam envelope evolution in free air and depth-dose profiles to within an accuracy on the order of ±5% for all tested energies, and that it was able to reproduce the 150 MeV passively scattered field to the specifications need for clinical and radiobiological applications.

This study describes a new approach for material decomposition in x-ray imaging, utilizing phase contrast both to increase sensitivity to weakly attenuating samples and to act as a complementary measurement to attenuation, therefore allowing two overlaid materials to be separated. The measurements are captured using the single-exposure, single-grid x-ray phase contrast imaging technique, with a novel correction that aims to remove propagation-based phase effects seen at sharp edges in the attenuation image. The use of a single-exposure technique means that images can be collected in a high-speed sequence. Results are shown for both a known two-material sample and for a biological specimen.