Universität zu Köln

Visser, Sabine, Ribeiro, Cassia O., Dieters, Margriet, Mul, Veronique E., Niezink, Anne G. H., van der Schaaf, Arjen, Knopf, Antje-Christin, Langendijk, Johannes A. ORCID: 0000-0003-1083-372X, Korevaar, Erik W., Both, Stefan and Muijs, Christina T. (2022). Robustness assessment of clinical adaptive proton and photon radiotherapy for oesophageal cancer in the model-based approach. Radiother. Oncol., 177. S. 197 - 205. CLARE: ELSEVIER IRELAND LTD. ISSN 1879-0887

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Abstract

Purpose: In the Netherlands, oesophageal cancer (EC) patients are selected for intensity modulated pro-ton therapy (IMPT) using the expected normal tissue complication probability reduction (DNTCP) 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 cov-erage degraded, replanning was performed. Target coverage was evaluated for complete treatment tra-jectories 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 DNTCP 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. (c) 2022 The Author(s). Published by Elsevier B.V. Radiotherapy and Oncology 177 (2022) 197-204 This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Visser, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Ribeiro, Cassia O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dieters, Margriet UNSPECIFIED UNSPECIFIED UNSPECIFIED Mul, Veronique E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Niezink, Anne G. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED van der Schaaf, Arjen UNSPECIFIED UNSPECIFIED UNSPECIFIED Knopf, Antje-Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Langendijk, Johannes A. UNSPECIFIED orcid.org/0000-0003-1083-372X UNSPECIFIED Korevaar, Erik W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Both, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Muijs, Christina T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-669332
DOI:	10.1016/j.radonc.2022.11.001
Journal or Publication Title:	Radiother. Oncol.
Volume:	177
Page Range:	S. 197 - 205
Date:	2022
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1879-0887
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TREATMENT UNCERTAINTIES; RADIATION-THERAPY; CHEMORADIOTHERAPY; IMPLEMENTATION; COMPLICATIONS; SENSITIVITY; PREDICTORS; STRATEGIES; SURVIVAL; PATIENT Multiple languages Oncology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66933