If the brain metastases are located close to organ-at-risk [OAR] like pituitary, optic chiasma, hippocampus, proton have a well defined beam will preserve those OAR better. The integral dose or scattered dose will be less even compared to photon stereotactic radiotherapy. Best regards, I would like to collaborate with you. My email is [email protected]. I am guest editor of a special issue on artificial intelligence on cancer treatment. The journal accepts paper free of charge. LET ME KNOW YOUR DECISION.

When considering proton therapy, it is important to select patients who may benefit most: those with recurrent disease, diffuse leptomeningeal spread, or a long expected survival where reducing late toxicity is crucial. Before choosing this modality, multidisciplinary evaluation is necessary to ensure appropriate patient selection, as evidence for routine use is still emerging and proton therapy is less widely available than conventional radiation.

Practical recommendations include prioritizing proton therapy for cases with lesions adjacent to radiosensitive structures, patients who require re-irradiation, and instances where reducing side effects is especially important. Individual treatment must be guided by tumor characteristics, prior therapies, performance status, and local access to technology. In most situations, conventional photon-based SRS or whole-brain radiotherapy remains the standard approach, with protons serving as an alternative for selected complex cases.

AGREE ENTIRELY WITH YOUR RECOMMENDATIONS.

Patricia Tai , which journal are we talking about (would you accept AI applied to radiotherapy with Ethos system)?Thanks

I do not understand your question. Most of my radiotherapy papers go to green or red or blue journals. Blue journal means J clin Oncol. Some goes to cancer, current oncology. Hope it replies your question OK. They all like to read about Ethos system or AI...Do you have any suggestions as well?

Nice. Thank you for the answer. I meant in which journal you collaborate as editorial guest. My current research line (and PhD project) is about Simulation free online adaptive radiotherapy: feasability, characterization and clinical application

I am the guest editor of Exploration of medicine and also current oncology. Do you want to publish there? Tell me what U want to write and I can add your idea/paper in.

submission to exploration of medicine is free of charge. There is a fee for current oncology.

thank you for the info. My field is radio-oncology, so I will have a look into current oncology