Complete patient exposure during paediatric brain cancer treatment for photon and proton therapy techniques including imaging procedures.
| Autor: | De Saint-Hubert M; Belgian Nuclear Research Center (SCK CEN), Mol, Belgium., Boissonnat G; CEA, Université Paris-Saclay, Palaiseau, France., Schneider U; Physik Institut, Universitat Zürich, Zürich, Switzerland., Bäumer C; West German Proton Therapy Centre Essen WPE, Essen, Germany.; West German Cancer Centre (WTZ), Essen, Germany.; Radiation Oncology and Imaging, German Cancer Consortium DKTK, Essen, Germany.; Department of Physics, TU Dortmund University, Dortmund, Germany., Verbeek N; West German Proton Therapy Centre Essen WPE, Essen, Germany.; West German Cancer Centre (WTZ), Essen, Germany., Esser J; West German Proton Therapy Centre Essen WPE, Essen, Germany.; West German Cancer Centre (WTZ), Essen, Germany.; Faculty of Mathematics and Science Institute of Physics and Medical Physics, Heinrich-Heine University, Düsseldorf, Germany., Wulff J; West German Proton Therapy Centre Essen WPE, Essen, Germany.; West German Cancer Centre (WTZ), Essen, Germany., Stuckmann F; West German Proton Therapy Centre Essen WPE, Essen, Germany.; West German Cancer Centre (WTZ), Essen, Germany., Suesselbeck F; West German Proton Therapy Centre Essen WPE, Essen, Germany.; West German Cancer Centre (WTZ), Essen, Germany., Nabha R; Belgian Nuclear Research Center (SCK CEN), Mol, Belgium., Dabin J; Belgian Nuclear Research Center (SCK CEN), Mol, Belgium., Vasi F; Physik Institut, Universitat Zürich, Zürich, Switzerland., Radonic S; Physik Institut, Universitat Zürich, Zürich, Switzerland., Rodriguez M; Hospital Paitilla, Panama City, Panama.; Instituto de Investigaciones Científicas y de Alta Tecnología INDICASAT-AIP, Panama City, Panama., Simon AC; CEA, Université Paris-Saclay, Palaiseau, France., Journy N; INSERM U1018, Paris Sud-Paris Saclay University, Villejuif, France., Timmermann B; West German Proton Therapy Centre Essen WPE, Essen, Germany.; West German Cancer Centre (WTZ), Essen, Germany.; Radiation Oncology and Imaging, German Cancer Consortium DKTK, Essen, Germany.; Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.; Department of Particle Therapy, University Hospital Essen, Essen, Germany., Thierry-Chef I; Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.; University Pompeu Fabra, Barcelona, Spain.; CIBER Epidemiología y Salud Pública, Madrid, Spain., Brualla L; West German Proton Therapy Centre Essen WPE, Essen, Germany.; West German Cancer Centre (WTZ), Essen, Germany.; Radiation Oncology and Imaging, German Cancer Consortium DKTK, Essen, Germany.; Faculty of Medicine, University of Duisburg-Essen, Essen, Germany. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in oncology [Front Oncol] 2023 Sep 19; Vol. 13, pp. 1222800. Date of Electronic Publication: 2023 Sep 19 (Print Publication: 2023). |
| DOI: | 10.3389/fonc.2023.1222800 |
| Abstrakt: | Background: In radiotherapy, especially when treating children, minimising exposure of healthy tissue can prevent the development of adverse outcomes, including second cancers. In this study we propose a validated Monte Carlo framework to evaluate the complete patient exposure during paediatric brain cancer treatment. Materials and Methods: Organ doses were calculated for treatment of a diffuse midline glioma (50.4 Gy with 1.8 Gy per fraction) on a 5-year-old anthropomorphic phantom with 3D-conformal radiotherapy, intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and intensity modulated pencil beam scanning (PBS) proton therapy. Doses from computed tomography (CT) for planning and on-board imaging for positioning (kV-cone beam CT and X-ray imaging) accounted for the estimate of the exposure of the patient including imaging therapeutic dose. For dose calculations we used validated Monte Carlo-based tools (PRIMO, TOPAS, PENELOPE), while lifetime attributable risk (LAR) was estimated from dose-response relationships for cancer induction, proposed by Schneider et al. Results: Out-of-field organ dose equivalent data of proton therapy are lower, with doses between 0.6 mSv (testes) and 120 mSv (thyroid), when compared to photon therapy revealing the highest out-of-field doses for IMRT ranging between 43 mSv (testes) and 575 mSv (thyroid). Dose delivered by CT ranged between 0.01 mSv (testes) and 72 mSv (scapula) while a single imaging positioning ranged between 2 Conclusion: The complete patient exposure during paediatric brain cancer treatment was estimated by combining the results from different Monte Carlo-based dosimetry tools, showing that proton therapy allows significant reduction of the out-of-field doses and secondary cancer risk in selected organs. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 De Saint-Hubert, Boissonnat, Schneider, Bäumer, Verbeek, Esser, Wulff, Stuckmann, Suesselbeck, Nabha, Dabin, Vasi, Radonic, Rodriguez, Simon, Journy, Timmermann, Thierry-Chef and Brualla.) |
| Databáze: | MEDLINE |
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