Krista C J Wink1, Erik Roelofs2, Charles B Simone3, David Dechambre4, Alina Santiago5, Judith van der Stoep2, Wim Dries6, Julia Smits6, Stephen Avery7, Filippo Ammazzalorso5, Nicolas Jansen4, Urszula Jelen5, Timothy Solberg8, Dirk de Ruysscher2, Esther G C Troost9. 1. Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands. Electronic address: krista.wink@maastro.nl. 2. Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands. 3. Hospital of the University of Pennsylvania, Department of Radiation Oncology, Philadelphia, USA; University of Maryland Medical Center, Department of Radiation Oncology, Baltimore, USA. 4. University Hospital of Liege (CHU), Department of Radiation Oncology, Belgium. 5. Department of Radiotherapy and Radiation Oncology, University of Marburg, Germany. 6. Catharina Hospital, Department of Radiation Oncology, Eindhoven, The Netherlands. 7. Hospital of the University of Pennsylvania, Department of Radiation Oncology, Philadelphia, USA. 8. Hospital of the University of Pennsylvania, Department of Radiation Oncology, Philadelphia, USA; University of California, San Francisco, USA. 9. Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands; Institute of Radiooncology - OncoRay, Helmholtz Zentrum Dresden - Rossendorf, Dresden, Germany; OncoRay, National Center for Radiation Research in Oncology, Dresden, Germany; Department of Radiation Oncology, University Hospital Carl Gustav Carus of Technische Universität Dresden, Germany; German Cancer Consortium (DKTK), Partnersite Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.
Abstract
PURPOSE: To compare dose to organs at risk (OARs) and dose-escalation possibility for 24 stage I non-small cell lung cancer (NSCLC) patients in a ROCOCO (Radiation Oncology Collaborative Comparison) trial. METHODS: For each patient, 3 photon plans [Intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and CyberKnife], a double scattered proton (DSP) and an intensity-modulated carbon-ion (IMIT) therapy plan were created. Dose prescription was 60 Gy (equivalent) in 8 fractions. RESULTS: The mean dose and dose to 2% of the clinical target volume (CTV) were lower for protons and ions compared with IMRT (p < 0.01). Doses to the lungs, heart, and mediastinal structures were lowest with IMIT (p < 0.01), doses to the spinal cord were lowest with DSP (p < 0.01). VMAT and CyberKnife allowed for reduced doses to most OARs compared with IMRT. Dose escalation was possible for 8 patients. Generally, the mediastinum was the primary dose-limiting organ. CONCLUSION: On average, the doses to the OARs were lowest using particles, with more homogenous CTV doses. Given the ability of VMAT and CyberKnife to limit doses to OARs compared with IMRT, the additional benefit of particles may only be clinically relevant in selected patients and thus should be carefully weighed for every individual patient.
PURPOSE: To compare dose to organs at risk (OARs) and dose-escalation possibility for 24 stage I non-small cell lung cancer (NSCLC) patients in a ROCOCO (Radiation Oncology Collaborative Comparison) trial. METHODS: For each patient, 3 photon plans [Intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and CyberKnife], a double scattered proton (DSP) and an intensity-modulated carbon-ion (IMIT) therapy plan were created. Dose prescription was 60 Gy (equivalent) in 8 fractions. RESULTS: The mean dose and dose to 2% of the clinical target volume (CTV) were lower for protons and ions compared with IMRT (p < 0.01). Doses to the lungs, heart, and mediastinal structures were lowest with IMIT (p < 0.01), doses to the spinal cord were lowest with DSP (p < 0.01). VMAT and CyberKnife allowed for reduced doses to most OARs compared with IMRT. Dose escalation was possible for 8 patients. Generally, the mediastinum was the primary dose-limiting organ. CONCLUSION: On average, the doses to the OARs were lowest using particles, with more homogenous CTV doses. Given the ability of VMAT and CyberKnife to limit doses to OARs compared with IMRT, the additional benefit of particles may only be clinically relevant in selected patients and thus should be carefully weighed for every individual patient.
Authors: N Shaverdian; J Beattie; M Thor; M Offin; A F Shepherd; D Y Gelblum; A J Wu; C B Simone; M D Hellmann; J E Chaft; A Rimner; D R Gomez Journal: Ann Oncol Date: 2020-09-30 Impact factor: 32.976
Authors: Esther G C Troost; Krista C J Wink; Erik Roelofs; Charles B Simone; Sebastian Makocki; Steffen Löck; Peter van Kollenburg; David Dechambre; Andre W H Minken; Judith van der Stoep; Stephen Avery; Nicolas Jansen; Timothy Solberg; Johan Bussink; Dirk de Ruysscher Journal: Br J Radiol Date: 2019-12-20 Impact factor: 3.039
Authors: Shivam M Kharod; R Charles Nichols; Randal H Henderson; Christopher G Morris; Dat C Pham; Vandana K Seeram; Lisa M Jones; Maria Antonio-Miranda; Daniel A Siragusa; Zuofeng Li; Stella Flampouri; Bradford S Hoppe Journal: Int J Part Ther Date: 2020-11-06
Authors: Jennifer S Chiang; Nathan Y Yu; Thomas B Daniels; Wei Liu; Steven E Schild; Terence T Sio Journal: J Thorac Dis Date: 2021-02 Impact factor: 2.895