Normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer

Background and purpose: Photons and protons have fundamentally different properties, i.e. protons have a reduced dose bath but a higher relative biological effectiveness. Photon-based normal tissue complication probability (NTCP) models may therefore not immediately be applicable to proton therapy (...

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Autores principales:	Jesper Pedersen, Xiaoying Liang, Curtis Bryant, Nancy Mendenhall, Zuofeng Li, Ludvig P. Muren
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Proton therapy Biological modelling Prostate Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/532b4b3cca3448528a1b74031edc16cb
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spelling	oai:doaj.org-article:532b4b3cca3448528a1b74031edc16cb2021-11-10T04:29:28ZNormal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer2405-631610.1016/j.phro.2021.10.004https://doaj.org/article/532b4b3cca3448528a1b74031edc16cb2021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405631621000610https://doaj.org/toc/2405-6316Background and purpose: Photons and protons have fundamentally different properties, i.e. protons have a reduced dose bath but a higher relative biological effectiveness. Photon-based normal tissue complication probability (NTCP) models may therefore not immediately be applicable to proton therapy (PT). The aim was to derive parameters of the Lyman-Kutcher-Burman (LKB) NTCP model using prospectively recorded late morbidity data from PT, focusing on rectal morbidity and prostate cancer. Materials and methods: Prospectively collected data were available for 1151 prostate cancer patients treated with passive scattering PT and prescribed target doses of 78–82 Gy (RBE = 1.1) in 2 Gy fractions. Morbidity data (CTCAE v3.0) consisted of two alternative late grade 2 rectal bleeding endpoints: Medical Grade2A (GR2A) and procedural Grade2B (GR2B), as well as late grade 3 + urinary morbidity. GR2A + 2B were observed in 156/1047 patients (15%), GR2B in 45/1047 patients (4%), and urinary grade 3 + in 51/1151 patients (4%). LKB NTCP model parameters (D50, m, and n) were derived by maximum likelihood estimation. Results: For the rectum/rectal wall the volume parameter n was low (0.07–0.14) for both GR2A + 2B and GR2B, as was the m parameter (range: 0.16–0.20). For the bladder/bladder wall both parameters were high (n-range: 0.20–0.36; m-range: 0.32–0.36). D50 parameters were higher for GR2B of the rectum/rectal wall (95.9–98.0 Gy) and bladder/bladder wall (118.1–119.9 Gy), but lower for GR2A2B (71.7–73.6 Gy). Conclusion: PT specific LKB NTCP model parameters were derived from a population of more than 1000 patients. The D50 parameter differed for all structures and endpoints and deviated from typical photon-based LKB model values.Jesper PedersenXiaoying LiangCurtis BryantNancy MendenhallZuofeng LiLudvig P. MurenElsevierarticleProton therapyBiological modellingProstateMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENPhysics and Imaging in Radiation Oncology, Vol 20, Iss , Pp 62-68 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Proton therapy Biological modelling Prostate Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Proton therapy Biological modelling Prostate Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jesper Pedersen Xiaoying Liang Curtis Bryant Nancy Mendenhall Zuofeng Li Ludvig P. Muren Normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer
description	Background and purpose: Photons and protons have fundamentally different properties, i.e. protons have a reduced dose bath but a higher relative biological effectiveness. Photon-based normal tissue complication probability (NTCP) models may therefore not immediately be applicable to proton therapy (PT). The aim was to derive parameters of the Lyman-Kutcher-Burman (LKB) NTCP model using prospectively recorded late morbidity data from PT, focusing on rectal morbidity and prostate cancer. Materials and methods: Prospectively collected data were available for 1151 prostate cancer patients treated with passive scattering PT and prescribed target doses of 78–82 Gy (RBE = 1.1) in 2 Gy fractions. Morbidity data (CTCAE v3.0) consisted of two alternative late grade 2 rectal bleeding endpoints: Medical Grade2A (GR2A) and procedural Grade2B (GR2B), as well as late grade 3 + urinary morbidity. GR2A + 2B were observed in 156/1047 patients (15%), GR2B in 45/1047 patients (4%), and urinary grade 3 + in 51/1151 patients (4%). LKB NTCP model parameters (D50, m, and n) were derived by maximum likelihood estimation. Results: For the rectum/rectal wall the volume parameter n was low (0.07–0.14) for both GR2A + 2B and GR2B, as was the m parameter (range: 0.16–0.20). For the bladder/bladder wall both parameters were high (n-range: 0.20–0.36; m-range: 0.32–0.36). D50 parameters were higher for GR2B of the rectum/rectal wall (95.9–98.0 Gy) and bladder/bladder wall (118.1–119.9 Gy), but lower for GR2A2B (71.7–73.6 Gy). Conclusion: PT specific LKB NTCP model parameters were derived from a population of more than 1000 patients. The D50 parameter differed for all structures and endpoints and deviated from typical photon-based LKB model values.
format	article
author	Jesper Pedersen Xiaoying Liang Curtis Bryant Nancy Mendenhall Zuofeng Li Ludvig P. Muren
author_facet	Jesper Pedersen Xiaoying Liang Curtis Bryant Nancy Mendenhall Zuofeng Li Ludvig P. Muren
author_sort	Jesper Pedersen
title	Normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer
title_short	Normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer
title_full	Normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer
title_fullStr	Normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer
title_full_unstemmed	Normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer
title_sort	normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/532b4b3cca3448528a1b74031edc16cb
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_version_	1718440647185137664

Normal tissue complication probability models for prospectively scored late rectal and urinary morbidity after proton therapy of prostate cancer

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