Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas

Background and purpose: Patients with lower-grade gliomas are long-term survivors after radiotherapy and may benefit from the reduced dose to normal tissue achievable with proton therapy. Here, we aimed to quantify differences in dose to the uninvolved brain and contralateral hippocampus and compare...

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Autores principales:	Camilla S. Byskov, Christian R. Hansen, Rikke H. Dahlrot, Lene Haldbo-Classen, Charlotte A. Haslund, Flemming Kjær-Kristoffersen, Thomas O. Kristensen, Yasmin Lassen-Ramshad, Slávka Lukacova, Aida Muhic, Petra W. Nyström, Britta Weber, Jesper F. Kallehauge
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Brain cancer Radiotherapy proton therapy Treatment Planning secondary cancer risk Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/700066f311f846f2ba899f205a2a9a01
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spelling	oai:doaj.org-article:700066f311f846f2ba899f205a2a9a012021-11-30T04:16:29ZTreatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas2405-631610.1016/j.phro.2021.11.008https://doaj.org/article/700066f311f846f2ba899f205a2a9a012021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405631621000725https://doaj.org/toc/2405-6316Background and purpose: Patients with lower-grade gliomas are long-term survivors after radiotherapy and may benefit from the reduced dose to normal tissue achievable with proton therapy. Here, we aimed to quantify differences in dose to the uninvolved brain and contralateral hippocampus and compare the risk of radiation-induced secondary cancer for photon and proton plans for lower-grade glioma patients. Materials and methods: Twenty-three patients were included in this in-silico planning comparative study and had photon and proton plans calculated (50.4 Gy(RBE = 1.1), 28 Fx) applying similar dose constraints to the target and organs at risk. Automatically calculated photon plans were generated with a 3 mm margin from clinical target volume (CTV) to planning target volume. Manual proton plans were generated using robust optimisation on the CTV. Dose metrics of organs at risk were compared using population mean dose-volume histograms and Wilcoxon signed-rank test. Secondary cancer risk per 10,000 persons per year (PPY) was estimated using dose-volume data and a risk model for secondary cancer induction. Results: CTV coverage (V95%>98%) was similar for the two treatment modalities. Mean dose (Dmean) to the uninvolved brain was significantly reduced from 21.5 Gy (median, IQR 17.1–24.4 Gy) with photons compared to 10.3 Gy(RBE) (8.1–13.9 Gy(RBE)) with protons. Dmean to the contralateral hippocampus was significantly reduced from 6.5 Gy (5.4–11.7 Gy) with photons to 1.5 Gy(RBE) (0.4–6.8 Gy(RBE)) with protons. The estimated secondary cancer risk was reduced from 6.7 PPY (median, range 3.3–10.4 PPY) with photons to 3.0 PPY (1.3–7.5 PPY) with protons. Conclusion: A significant reduction in mean dose to uninvolved brain and contralateral hippocampus was found with proton planning. The estimated secondary cancer risk was reduced with proton therapy.Camilla S. ByskovChristian R. HansenRikke H. DahlrotLene Haldbo-ClassenCharlotte A. HaslundFlemming Kjær-KristoffersenThomas O. KristensenYasmin Lassen-RamshadSlávka LukacovaAida MuhicPetra W. NyströmBritta WeberJesper F. KallehaugeElsevierarticleBrain cancerRadiotherapyproton therapyTreatment Planningsecondary cancer riskMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENPhysics and Imaging in Radiation Oncology, Vol 20, Iss , Pp 98-104 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Brain cancer Radiotherapy proton therapy Treatment Planning secondary cancer risk Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Brain cancer Radiotherapy proton therapy Treatment Planning secondary cancer risk Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Camilla S. Byskov Christian R. Hansen Rikke H. Dahlrot Lene Haldbo-Classen Charlotte A. Haslund Flemming Kjær-Kristoffersen Thomas O. Kristensen Yasmin Lassen-Ramshad Slávka Lukacova Aida Muhic Petra W. Nyström Britta Weber Jesper F. Kallehauge Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas
description	Background and purpose: Patients with lower-grade gliomas are long-term survivors after radiotherapy and may benefit from the reduced dose to normal tissue achievable with proton therapy. Here, we aimed to quantify differences in dose to the uninvolved brain and contralateral hippocampus and compare the risk of radiation-induced secondary cancer for photon and proton plans for lower-grade glioma patients. Materials and methods: Twenty-three patients were included in this in-silico planning comparative study and had photon and proton plans calculated (50.4 Gy(RBE = 1.1), 28 Fx) applying similar dose constraints to the target and organs at risk. Automatically calculated photon plans were generated with a 3 mm margin from clinical target volume (CTV) to planning target volume. Manual proton plans were generated using robust optimisation on the CTV. Dose metrics of organs at risk were compared using population mean dose-volume histograms and Wilcoxon signed-rank test. Secondary cancer risk per 10,000 persons per year (PPY) was estimated using dose-volume data and a risk model for secondary cancer induction. Results: CTV coverage (V95%>98%) was similar for the two treatment modalities. Mean dose (Dmean) to the uninvolved brain was significantly reduced from 21.5 Gy (median, IQR 17.1–24.4 Gy) with photons compared to 10.3 Gy(RBE) (8.1–13.9 Gy(RBE)) with protons. Dmean to the contralateral hippocampus was significantly reduced from 6.5 Gy (5.4–11.7 Gy) with photons to 1.5 Gy(RBE) (0.4–6.8 Gy(RBE)) with protons. The estimated secondary cancer risk was reduced from 6.7 PPY (median, range 3.3–10.4 PPY) with photons to 3.0 PPY (1.3–7.5 PPY) with protons. Conclusion: A significant reduction in mean dose to uninvolved brain and contralateral hippocampus was found with proton planning. The estimated secondary cancer risk was reduced with proton therapy.
format	article
author	Camilla S. Byskov Christian R. Hansen Rikke H. Dahlrot Lene Haldbo-Classen Charlotte A. Haslund Flemming Kjær-Kristoffersen Thomas O. Kristensen Yasmin Lassen-Ramshad Slávka Lukacova Aida Muhic Petra W. Nyström Britta Weber Jesper F. Kallehauge
author_facet	Camilla S. Byskov Christian R. Hansen Rikke H. Dahlrot Lene Haldbo-Classen Charlotte A. Haslund Flemming Kjær-Kristoffersen Thomas O. Kristensen Yasmin Lassen-Ramshad Slávka Lukacova Aida Muhic Petra W. Nyström Britta Weber Jesper F. Kallehauge
author_sort	Camilla S. Byskov
title	Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas
title_short	Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas
title_full	Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas
title_fullStr	Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas
title_full_unstemmed	Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas
title_sort	treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/700066f311f846f2ba899f205a2a9a01
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Treatment plan comparison of proton vs photon radiotherapy for lower-grade gliomas

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