Camilla H Stokkevåg1, Mai Fukahori2, Takuma Nomiya3, Naruhiro Matsufuji2, Grete May Engeseth4, Liv B Hysing4, Kristian S Ytre-Hauge5, Eivind Rørvik5, Artur Szostak5, Ludvig P Muren6. 1. Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway; Department of Physics and Technology, University of Bergen, Norway. Electronic address: camilla.hanquist.stokkevag@helse-bergen.no. 2. Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan. 3. Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan; Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan. 4. Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway. 5. Department of Physics and Technology, University of Bergen, Norway. 6. Department of Medical Physics, Aarhus University/Aarhus University Hospital, Denmark.
Abstract
BACKGROUND AND PURPOSE: Radiation-induced cancer is a serious late effect that may follow radiotherapy. A considerable uncertainty is associated with carcinogenesis from photon-based treatment, and even less established when including relative biological effectiveness (RBE) for particle therapy. The aim of this work was therefore to estimate and in particular explore relative risks (RR) of secondary cancer (SC) following particle therapy as applied in treatment of prostate cancer. MATERIAL AND METHODS: RRs of radiation-induced SC in the bladder and rectum were estimated using a bell-shaped dose-response model incorporating RBE and fractionation effects. The risks from volumetric modulated arc therapy (VMAT) were compared to intensity-modulated proton therapy (IMPT) and scanning carbon ions for ten patients. RESULTS: The mean estimated RR (95% CI) of SC for VMAT/C-ion was 1.31 (0.65-2.18) for the bladder and 0.58 (0.41-0.80) for the rectum. Corresponding values for VMAT/IMPT were 1.72 (1.06-2.37) and 1.10 (0.78-1.43). The radio-sensitivity parameter α had the strongest influence on the results with decreasing RR for increasing values of α. CONCLUSION: Based on the wide spread in RR between patients and variations across the included parameter values, the risk profiles of the rectum and bladder were not dramatically different for the investigated radiotherapy techniques.
BACKGROUND AND PURPOSE: Radiation-induced cancer is a serious late effect that may follow radiotherapy. A considerable uncertainty is associated with carcinogenesis from photon-based treatment, and even less established when including relative biological effectiveness (RBE) for particle therapy. The aim of this work was therefore to estimate and in particular explore relative risks (RR) of secondary cancer (SC) following particle therapy as applied in treatment of prostate cancer. MATERIAL AND METHODS: RRs of radiation-induced SC in the bladder and rectum were estimated using a bell-shaped dose-response model incorporating RBE and fractionation effects. The risks from volumetric modulated arc therapy (VMAT) were compared to intensity-modulated proton therapy (IMPT) and scanning carbon ions for ten patients. RESULTS: The mean estimated RR (95% CI) of SC for VMAT/C-ion was 1.31 (0.65-2.18) for the bladder and 0.58 (0.41-0.80) for the rectum. Corresponding values for VMAT/IMPT were 1.72 (1.06-2.37) and 1.10 (0.78-1.43). The radio-sensitivity parameter α had the strongest influence on the results with decreasing RR for increasing values of α. CONCLUSION: Based on the wide spread in RR between patients and variations across the included parameter values, the risk profiles of the rectum and bladder were not dramatically different for the investigated radiotherapy techniques.
Authors: Nadine Erbeldinger; Felicitas Rapp; Svetlana Ktitareva; Philipp Wendel; Anna S Bothe; Till Dettmering; Marco Durante; Thomas Friedrich; Bianca Bertulat; Stephanie Meyer; M C Cardoso; Stephanie Hehlgans; Franz Rödel; Claudia Fournier Journal: Front Immunol Date: 2017-06-01 Impact factor: 7.561