Methods for treating tumors by administering FLASH radiation and a therapeutic agent to a patient with cancer are disclosed. The methods provide the dual benefits of anti-tumor efficacy plus normal tissue protection when combining therapeutic agents with FLASH radiation to treat cancer patients. The methods described herein also allow for the classification of patients into groups for receiving optimized radiation treatment in combination with a therapeutic agent based on patient-specific biomarker signatures. Also provided are radiation treatment planning methods and systems incorporating FLASH radiation and therapeutic agents.

Embodiments of systems, devices, and methods relate to exclusion of ion beam paths on the target surface to optimize neutron beam performance. A particle beam is directed along an axis so that the particle beam is incident on a target positioned on the particle beam axis. The target has a scannable surface extending over an area substantially orthogonal to the axis. The particle beam is scanned across the scannable surface of the target along a first path having a first flux. The particle beam, having a second flux, is scanned across the scannable surface of the target along a second path that is within an exclusion area of the target.

A control circuit accesses historical information regarding previously optimized radiation treatment plans for different patients and processes that information to determine the relative importance of different clinical goals. The circuit then facilitates development of a particular plan for a particular patient as a function of the relative importance of the clinical goals. By one approach the control circuit can be configured as a radiation treatment plan recommendation resource that accesses a database of radiation treatment plan formulation content items including at least one of a radiation treatment plan template, an auto-planning algorithm, and an auto-segmentation algorithm. By one approach the control circuit can be configured to, when presenting automatically-generated radiation treatment plans to a user, also co-present an opportunity for the user to signal to a remote entity that none of the plans are acceptable and that the user will instead employ a user-generated plan for the particular patient.

A method for creating an irradiation plan. The method may include receiving an irradiation therapy plan for irradiating a target with a proton beam from a gantry. The irradiation therapy plan may have a plurality of irradiation spots for delivering protons to the target. The method may include identifying a rotational profile for angular rotation of the gantry with respect to the target, a slew time for a proton beam to travel between each of the plurality of irradiation spots, and an amount of protons to be delivered to each irradiation spot. The method may also include creating an irradiation plan. The irradiation plan may include a plurality of groups of irradiation spots based on the rotational profile, the slew time, and the amount of protons to be delivered to each irradiation spot. Each group of irradiation spots may be associated with a respective portion of the angular rotation.

An imaging apparatus comprises a rotatable gantry system positioned at least partially around a patient support; a first source of radiation coupled to the rotatable gantry system, the first source of radiation configured for imaging radiation; a second source of radiation coupled to the rotatable gantry system; and a first radiation detector coupled to the rotatable gantry system and laterally movable relative to a central beam of the first source of radiation to receive radiation from at least the first source of radiation over various fields of view. Alternative configurations of the imaging apparatus and methods of using the imaging apparatus are also provided.

A compensating device for use in ion-based radiotherapy may comprise a disk with a number of protrusions may be placed in a radiation beam to affect the ions in the beam in different ways to create an irradiation field from a broad beam. This is particularly useful in FLASH therapy because of the limited time available or modulating the beam. A method of designing such a compensating device is proposed, comprising the steps of obtaining characteristics of an actual treatment plan comprising at least one beam, determining at least one parameter characteristic of the desired energy modulation of the actual plan by performing a dose calculation of the initial plan and, based on the at least one parameter, computing a shape for each of the plurality of elongated elements to modulate the dose of the delivery beam to mimic the dose of the initial plan per beam.

A computer implemented method for optimizing tolerance values of operating parameters of a particle accelerating system allowing a plurality of beamlets of particles accelerated along an irradiation axis, to deposit doses by pencil beam scanning into a structure of interest of a patient according to a treatment plan. The method calculates the dose (rate) volume histograms for a statistically representative number N of values randomly selected within a defined confidence level in preselected tentative statistical distributions of the operating parameters and compares the obtained calculated dose (rate) volume histogram with an acceptable band of variation of a target dose (rate) volume histogram. Once a tentative statistical distribution yields N calculated dose (rate) volume histograms which all fall within the acceptable band of variation, it is set as the final statistical distribution, and the particle accelerating system can be programmed with the final statistical distribution.

Radiation treatment planning includes determining a number of beams to be directed into a target, determining directions (e.g., gantry angles) for the beams, and determining an energy level for each of the beams. The number of beams, the directions of the beams, and the energy levels are determined such that the beams do not overlap outside the target and the prescribed dose will be delivered across the entire target.

It is provided a method for generating a plurality of treatment plans for radiation therapy, each treatment plan specifying weights for a plurality of geometrically defined fluence elements. Each weight defines an amount of radiation fluence, to thereby provide radiation dose to a target volume. The method is performed in a treatment planning system and comprises the steps of: generating a first set of treatment plans; determining a subset of the fluence elements, based on the first set of treatment plans; and generating a second set of at least two treatment plans, wherein the treatment plans only contain weights for the subset of fluence elements.

The trajectory of a beam of charged particles within a patient may be changed by the application of a magnetic field. In that way, the position of the beam's Bragg peak may be controlled for a beam having a specific direction and energy.