Almut Dutz1, Armin Lühr2, Linda Agolli3, Esther G C Troost4, Mechthild Krause4, Michael Baumann5, Xavier Vermeren6, Dirk Geismar7, Emily F Schapira8, Meghan Bussière8, Jillian E Daly8, Marc R Bussière8, Beate Timmermann9, Helen A Shih8, Steffen Löck10. 1. OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; German Cancer Consortium (DKTK), partner site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany. Electronic address: almut.dutz@oncoray.de. 2. OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; German Cancer Consortium (DKTK), partner site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany. 3. OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. 4. OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; German Cancer Consortium (DKTK), partner site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden; German Cancer Research Center (DKFZ), Heidelberg; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden; Helmholtz Association / Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany. 5. OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; German Cancer Consortium (DKTK), partner site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden; German Cancer Research Center (DKFZ), Heidelberg; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden; Helmholtz Association / Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany. 6. West German Proton Therapy Center Essen (WPE), University Hospital Essen, Germany. 7. West German Proton Therapy Center Essen (WPE), University Hospital Essen, Germany; Department of Particle Therapy, University Hospital Essen, Germany; West German Cancer Center (WTZ), University Hospital Essen, Germany. 8. Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, USA. 9. West German Proton Therapy Center Essen (WPE), University Hospital Essen, Germany; Department of Particle Therapy, University Hospital Essen, Germany; West German Cancer Center (WTZ), University Hospital Essen, Germany; German Cancer Consortium (DKTK), partner site Essen, Germany. 10. OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), partner site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden; German Cancer Research Center (DKFZ), Heidelberg; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden; Helmholtz Association / Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany.
Abstract
BACKGROUND: The limited availability of proton beam therapy (PBT) requires individual treatment selection strategies, such as based on normal tissue complication probability (NTCP). We developed and externally validated NTCP models for common acute side-effects following PBT in brain tumour patients in effort to provide guidance on optimising patient quality of life. METHODS: An exploration cohort including 113 adult brain tumour patients who underwent PBT was investigated for the following endpoints: alopecia, scalp erythema, headache, fatigue and nausea. Dose-volume parameters of associated normal tissues were used for logistic regression modelling. Statistically significant parameters showing high area under the receiver operating characteristic curve (AUC) values in internal cross-validation were externally validated on two cohorts of 71 and 96 patients, respectively. RESULTS: Statistically significant correlations of dose-volume parameters of the skin for erythema and alopecia were found. In internal cross-validation, the following prognostic parameters were selected: V35Gy (absolute volume receiving 35 Gy) for erythema grade ≥1, D2% (dose to 2% of the volume) for alopecia grade ≥1 and D5% for alopecia grade ≥2. Validation was successful for both cohorts with AUC >0.75. A bivariable model for fatigue grade ≥1 could not be validated externally. No correlations of dose-volume parameters of the brain were seen for headache or nausea. CONCLUSION: We developed and successfully validated NTCP models for scalp erythema and alopecia in primary brain tumour patients treated with PBT.
BACKGROUND: The limited availability of proton beam therapy (PBT) requires individual treatment selection strategies, such as based on normal tissue complication probability (NTCP). We developed and externally validated NTCP models for common acute side-effects following PBT in brain tumourpatients in effort to provide guidance on optimising patient quality of life. METHODS: An exploration cohort including 113 adult brain tumourpatients who underwent PBT was investigated for the following endpoints: alopecia, scalp erythema, headache, fatigue and nausea. Dose-volume parameters of associated normal tissues were used for logistic regression modelling. Statistically significant parameters showing high area under the receiver operating characteristic curve (AUC) values in internal cross-validation were externally validated on two cohorts of 71 and 96 patients, respectively. RESULTS: Statistically significant correlations of dose-volume parameters of the skin for erythema and alopecia were found. In internal cross-validation, the following prognostic parameters were selected: V35Gy (absolute volume receiving 35 Gy) for erythema grade ≥1, D2% (dose to 2% of the volume) for alopecia grade ≥1 and D5% for alopecia grade ≥2. Validation was successful for both cohorts with AUC >0.75. A bivariable model for fatigue grade ≥1 could not be validated externally. No correlations of dose-volume parameters of the brain were seen for headache or nausea. CONCLUSION: We developed and successfully validated NTCP models for scalp erythema and alopecia in primary brain tumourpatients treated with PBT.
Authors: Lieke In 't Ven; Inge Compter; Kyra van Eijsden; Jaap Zindler; Ans Swinnen; Dirk de Ruysscher; Tom Rozema; Esther G C Troost; Daniëlle B P Eekers Journal: Clin Transl Radiat Oncol Date: 2022-02-14
Authors: F Raschke; K Witzmann; A Seidlitz; T Wesemann; C Jentsch; I Platzek; J van den Hoff; J Kotzerke; B Beuthien-Baumann; M Baumann; J Linn; M Krause; E G C Troost Journal: Clin Transl Radiat Oncol Date: 2022-07-20