Stage I NSCLC Radiotherapy Particle therapy In silico planning study Multicentric trial; Radiology, Nuclear Medicine and imaging; Oncology; Hematology; protons; carbo-ions; radiotherapy; lung cancer; compararive dosimetry; VMAT; NSCLC; IMRT
Abstract :
[en] To compare dose to organs at risk (OARs) and dose-escalation possibility for 24 stage I nonsmall 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.
Disciplines :
Oncology
Author, co-author :
Wink, Krista; Department of Radiation Oncology (MAASTRO), GROW -School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
Roelofs, Erik; Department of Radiation Oncology (MAASTRO), GROW -School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
Ii, Charles; Department of Radiation Oncology, University of Pennsylvania, Philadelphia ; Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, USA
Dechambre, David; Department of Radiation Oncology, University Hospital of Liege (CHU), Belgium
Santiago, Alina; Department of Radiotherapy and Radiation Oncology, University of Marburg, Germany
Van Der Stoep, Judith; Department of Radiation Oncology (MAASTRO), GROW -School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
Dries, Wim; Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands
Smits, Julia; Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands
Avery, Stephen; Department of Radiation Oncology, University of Pennsylvania, Philadelphia
Ammazzalorso, Filippo; Department of Radiotherapy and Radiation Oncology, University of Marburg, Germany
Jansen, Nicolas ; Centre Hospitalier Universitaire de Liège - CHU > > Service médical de radiothérapie
Jelen, Urszula; Department of Radiotherapy and Radiation Oncology, University of Marburg, Germany
Solberg, Timothy; Department of Radiation Oncology, University of Pennsylvania, Philadelphia ; University of California, San Francisco, USA
De Ruysscher, Dirk; Department of Radiation Oncology (MAASTRO), GROW -School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
Troost, Esther; 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 ; OncoRay, National Center for Radiation Research in Oncology, Dresden ; Department of Radiation Oncology, University Hospital Carl Gustav Carus of Technische Universität Dresden ; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
Photons, protons or carbon ions for stage I non-small cell lung cancer -Results of the multicentric ROCOCO in silico study
Alternative titles :
[fr] Des photons, protons ou carbo-ions pour le cancer pulmonaire non-à-petites cellules de stade I - Résultats d'une étude multicentrique ROCOCO 'in silico'
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