Robustness assessment of clinical adaptive proton and photon radiotherapy for oesophageal cancer in the model-based approach
Authors
Visser, Sabine
O. Ribeiro, Cássia
Dieters, Margriet
Mul, Veronique E.
Niezink, Anne G.H.
van der Schaaf, Arjen
Langendijk, Johannes A.
Korevaar, Erik W.
Both, Stefan
Muijs, Christina T.
Author (Corporation)
Publication date
12/2022
Typ of student thesis
Course of study
Type
01A - Journal article
Editors
Editor (Corporation)
Supervisor
Parent work
Radiotherapy and Oncology
Special issue
DOI of the original publication
Link
Series
Series number
Volume
177
Issue / Number
Pages / Duration
197-204
Patent number
Publisher / Publishing institution
Elsevier
Place of publication / Event location
Edition
Version
Programming language
Assignee
Practice partner / Client
Abstract
Purpose
In the Netherlands, oesophageal cancer (EC) patients are selected for intensity modulated proton therapy (IMPT) using the expected normal tissue complication probability reduction (ΔNTCP) when treating with IMPT compared to volumetric modulated arc therapy (VMAT). In this study, we evaluate the robustness of the first EC patients treated with IMPT in our clinic in terms of target and organs-at-risk (OAR) dose with corresponding NTCP, as compared to VMAT.
Materials and Methods
For 20 consecutive EC patients, clinical IMPT and VMAT plans were created on the average planning 4DCT. Both plans were robustly evaluated on weekly repeated 4DCTs and if target coverage degraded, replanning was performed. Target coverage was evaluated for complete treatment trajectories with and without replanning. The planned and accumulated mean lung dose (MLD) and mean heart dose (MHD) were additionally evaluated and translated into NTCP.
Results
Replanning in the clinic was performed more often for IMPT (15x) than would have been needed for VMAT (8x) (p = 0.11). Both adaptive treatments would have resulted in adequate accumulated target dose coverage. Replanning in the first week of treatment had most clinical impact, as anatomical changes resulting in insufficient accumulated target coverage were already observed at this stage. No differences were found in MLD between the planned dose and the accumulated dose. Accumulated MHD differed from the planned dose (p < 0.001), but since these differences were similar for VMAT and IMPT (1.0 and 1.5 Gy, respectively), the ΔNTCP remained unchanged.
Conclusion
Following an adaptive clinical workflow, adequate target dose coverage and stable OAR doses with corresponding NTCPs was assured for both IMPT and VMAT.
Keywords
IMPT, VMAT, Robustness, Oesophageal cancer, Dose accumulation, Model-based approach
Subject (DDC)
600 - Technik, Medizin, angewandte Wissenschaften
Event
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Exhibition end date
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Conference end date
Date of the last check
ISBN
ISSN
0167-8140
Language
English
Created during FHNW affiliation
No
Strategic action fields FHNW
Publication status
Published
Review
Peer review of the complete publication
Open access category
Hybrid
License
Citation
VISSER, Sabine, Cássia O. RIBEIRO, Margriet DIETERS, Veronique E. MUL, Anne G.H. NIEZINK, Arjen VAN DER SCHAAF, Johannes A. LANGENDIJK, Erik W. KOREVAAR, Stefan BOTH, Christina T. MUIJS und Antje KNOPF, 2022. Robustness assessment of clinical adaptive proton and photon radiotherapy for oesophageal cancer in the model-based approach. Radiotherapy and Oncology. Dezember 2022. Bd. 177, S. 197–204. DOI 10.1016/j.radonc.2022.11.001. Verfügbar unter: https://doi.org/10.26041/fhnw-4840