Gracinda Mondlane1, Michael Gubanski2, Pehr A Lind3, Ana Ureba4, Albert Siegbahn4. 1. Department of Physics - Medical Radiation Physics, Stockholm University, Stockholm, Sweden; Department of Physics, Universidade Eduardo Mondlane, Maputo, Mozambique. Electronic address: gracinda.mondlane@fysik.su.se. 2. Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden. 3. Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology, Södersjukhuset, Stockholm, Sweden. 4. Department of Physics - Medical Radiation Physics, Stockholm University, Stockholm, Sweden.
Abstract
INTRODUCTION: The potential of proton therapy to improve the sparing of the healthy tissue has been demonstrated in several studies. However, even small doses delivered to the organs at risk (OAR) may induce long-term detriments after radiotherapy. In this study, we investigated the possibility to reduce the risk of radiation-induced secondary cancers with intensity modulated proton therapy (IMPT), when used for radiosurgery of liver metastases. MATERIAL AND METHODS: Ten patients, previously treated for liver metastases with photon-beam based stereotactic body radiation therapy (SBRT) were retrospectively planned for radiosurgery with IMPT. A treatment plan comparison was then performed in terms of calculated risk of radiation-induced secondary cancer. The risks were estimated using two distinct models (Dasu et al., 2005; Schneider et al., 2005, 2009). The plans were compared pairwise with a two-sided Wilcoxon signed-rank test with a significance level of 0.05. RESULTS: Reduced risks for induction of fatal and other types of cancers were estimated for the IMPT plans (p<0.05) with the Dasu et al. MODEL: Using the Schneider et al. model, lower risks for carcinoma-induction with IMPT were estimated for the skin, lungs, healthy part of the liver, esophagus and the remaining part of the body (p<0.05). The risk of observing sarcomas in the bone was also reduced with IMPT (p<0.05). CONCLUSION: The findings of this study indicate that the risks of radiation-induced secondary cancers after radiosurgery of liver metastases may be reduced, if IMPT is used instead of photon-beam based SBRT.
INTRODUCTION: The potential of proton therapy to improve the sparing of the healthy tissue has been demonstrated in several studies. However, even small doses delivered to the organs at risk (OAR) may induce long-term detriments after radiotherapy. In this study, we investigated the possibility to reduce the risk of radiation-induced secondary cancers with intensity modulated proton therapy (IMPT), when used for radiosurgery of liver metastases. MATERIAL AND METHODS: Ten patients, previously treated for liver metastases with photon-beam based stereotactic body radiation therapy (SBRT) were retrospectively planned for radiosurgery with IMPT. A treatment plan comparison was then performed in terms of calculated risk of radiation-induced secondary cancer. The risks were estimated using two distinct models (Dasu et al., 2005; Schneider et al., 2005, 2009). The plans were compared pairwise with a two-sided Wilcoxon signed-rank test with a significance level of 0.05. RESULTS: Reduced risks for induction of fatal and other types of cancers were estimated for the IMPT plans (p<0.05) with the Dasu et al. MODEL: Using the Schneider et al. model, lower risks for carcinoma-induction with IMPT were estimated for the skin, lungs, healthy part of the liver, esophagus and the remaining part of the body (p<0.05). The risk of observing sarcomas in the bone was also reduced with IMPT (p<0.05). CONCLUSION: The findings of this study indicate that the risks of radiation-induced secondary cancers after radiosurgery of liver metastases may be reduced, if IMPT is used instead of photon-beam based SBRT.
Authors: Laila König; Juliane Hörner-Rieber; Matthew Forsthoefel; Peter Haering; Eva Meixner; Tanja Eichkorn; Anna Krämer; Thomas Mielke; Eric Tonndorf-Martini; Matthias F Haefner; Jürgen Debus; Jonathan W Lischalk Journal: Cancers (Basel) Date: 2022-05-13 Impact factor: 6.575
Authors: Laila König; Peter Haering; Clemens Lang; Mona Splinter; Bastian von Nettelbladt; Fabian Weykamp; Philipp Hoegen; Jonathan W Lischalk; Klaus Herfarth; Jürgen Debus; Juliane Hörner-Rieber Journal: Front Oncol Date: 2020-07-07 Impact factor: 6.244