Proton Radiation Therapy Fellowship at Royal Oak

Trainees will spend 9 - 12 months of the year on clinical radiation oncology services, which use proton radiation therapy. Up to three months of the year may be spent on clinical, physics, or biology research projects related to proton radiotherapy depending on the interests of the student and needs of the Department. While on clinical service, fellows will be expected to evaluate new patients under consideration for proton/photon radiation therapy, dictate appropriate consultation notes,  present the patient for discussion at Proton Rounds in the Department of Radiation Oncology and at other appropriate multidisciplinary patient management conferences (i.e. Sarcoma Conference, Pediatric Tumor Board, etc.), review diagnostic studies with the attending Radiation Oncologist and specialists from other services (i.e. Pathology, Diagnostic Radiology), and actively participate in the Proton/Photon Radiation Therapy treatment planning process. Currently, there is one fellow planned for year-long proton fellowship position.

• provide an in-depth clinical exposure to radiation therapy with protons
• develop understanding of physical interactions of protons with tissue and understanding of treatment planning with protons
• develop familiarity with clinical indications for use of protons
• develop understanding of differences in clinical proton and photon dosimetry
• develop understanding of normal tissue constraints utilized in proton radiation therapy planning
• develop understanding of clinical radiation therapy target volumes for proton radiation therapy
• refine understanding of most relevant tumor imaging
• become familiar with the relevant literature, which documents the most appropriate treatment strategies for patients undergoing proton radiation therapy
• become competent in radiation therapy planning and delivery in patients undergoing proton therapy, including use of required immobilization and CT simulation. The fellow should become proficient in the use of various immobilization strategies (casts, bite blocks), CT simulation techniques, and image fusion techniques. Time should be spent in the mold room observing immobilization devices being made.
• the Fellow should become familiar with ongoing clinical research trials available to patients with malignancies
• recognize patient factors such as age, performance and nutritional status that influence treatment management recommendations and tolerance of therapy
• become knowledgeable regarding treatment outcomes so that these can be discussed with the patient, family, and primary care and other involved physicians
• develop the communication skills required to deal with patients and their relatives following the diagnosis, during treatment, and on relapse should it occur. To develop a sensitivity and awareness of end of life issues
• become competent in the palliative management of these patients including pain management
• proton radiation may be used for benign disease such as arteriovenous malformations, meningiomas, acoustic neuromas, giant cell tumors, and others. The careful selection of cases and therapy will be taught.
• develop skill and become competent in treating patient with proton radiosurgery/body radiation treatment techniques
• learn the basics, and the foundations of Proton SRS and SBRT techniques
• be a competent physician treating patient independently in a clinical setting

Carrie Nieman
Program Coordinator
248.551.7032