Comparison of stereotactic radiotherapy and protons for uveal melanoma patients.

Autor:	Fleury E; Erasmus Medical Center Cancer Institute, University Medical Center, Department of Radiotherapy, Rotterdam, The Netherlands.; HollandPTC, Delft, The Netherlands., Pignol JP; College of Medicine, Al Faisal University, Riyadh, Saudi Arabia., Kiliç E; Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands.; Erasmus Medical Center, Department of Clinical Genetics, Rotterdam, The Netherlands., Milder M; Erasmus Medical Center Cancer Institute, University Medical Center, Department of Radiotherapy, Rotterdam, The Netherlands., van Rij C; Erasmus Medical Center Cancer Institute, University Medical Center, Department of Radiotherapy, Rotterdam, The Netherlands., Naus N; Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands., Yavuzyigitoglu S; Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands., den Toom W; Erasmus Medical Center Cancer Institute, University Medical Center, Department of Radiotherapy, Rotterdam, The Netherlands., Zolnay A; Erasmus Medical Center Cancer Institute, University Medical Center, Department of Radiotherapy, Rotterdam, The Netherlands., Spruijt K; HollandPTC, Delft, The Netherlands., van Vulpen M; HollandPTC, Delft, The Netherlands., Trnková P; Erasmus Medical Center Cancer Institute, University Medical Center, Department of Radiotherapy, Rotterdam, The Netherlands.; Medical University of Vienna, Department of Radiation Oncology, Vienna, Austria., Hoogeman M; Erasmus Medical Center Cancer Institute, University Medical Center, Department of Radiotherapy, Rotterdam, The Netherlands.; HollandPTC, Delft, The Netherlands.
Jazyk:	angličtina
Zdroj:	Physics and imaging in radiation oncology [Phys Imaging Radiat Oncol] 2024 Jun 26; Vol. 31, pp. 100605. Date of Electronic Publication: 2024 Jun 26 (Print Publication: 2024).
DOI:	10.1016/j.phro.2024.100605
Abstrakt:	Background and Purpose: Uveal melanoma (UM) is the most common primary ocular malignancy. We compared fractionated stereotactic radiotherapy (SRT) with proton therapy, including toxicity risks for UM patients. Materials and Methods: For a total of 66 UM patients from a single center, SRT dose distributions were compared to protons using the same planning CT. Fourteen dose-volume parameters were compared in 2-Gy equivalent dose per fraction (EQD2). Four toxicity profiles were evaluated: maculopathy, optic-neuropathy, visual acuity impairment (Profile I); neovascular glaucoma (Profile II); radiation-induced retinopathy (Profile III); and dry-eye syndrome (Profile IV). For Profile III, retina Mercator maps were generated to visualize the geographical location of dose differences. Results: In 9/66 cases, (14 %) proton plans were superior for all dose-volume parameters. Higher T stages benefited more from protons in Profile I, especially tumors located within 3 mm or less from the optic nerve. In Profile II, only 9/66 cases resulted in a better proton plan. In Profile III, better retina volume sparing was always achievable with protons, with a larger gain for T3 tumors. In Profile IV, protons always reduced the risk of toxicity with a median RBE-weighted EQD2 reduction of 15.3 Gy. Conclusions: This study reports the first side-by-side imaging-based planning comparison between protons and SRT for UM patients. Globally, while protons appear almost always better regarding the risk of optic-neuropathy, retinopathy and dry-eye syndrome, for other toxicity like neovascular glaucoma, a plan comparison is warranted. Choice would depend on the prioritization of risks. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: E. Fleury: The Department of Radiotherapy (Erasmus Medical Center Cancer Institute, The Netherlands) has research collaborations with Elekta AB, Stockholm, Sweden, Accuray Inc., Sunnyvale, CA, USA, Varian, Palo Alto, CA, USA, RaySearch Laboratories, Stockholm, Sweden, outside the submitted work. Prof. dr. Pignol: Prof. dr. Pignol was senior vice president, chief medical and technology officer at Accuray Inc., Sunnyvale, CA, USA until February 2023. Prof. dr. Hoogeman: Prof. dr. Hoogeman reports grants from Netherlands Organization for Scientific Research, grants from Varian, a Siemens Healthineers Company, Palo Alto, California, USA, during the conduct of the study; being a Member of advisory board Accuray, Sunnyvale, USA; being a participant/presenter at Accuray Thinktank Meeting on Prostate cancer, outside the submitted work; and The Department of Radiotherapy (Erasmus Medical Center Cancer Institute, The Netherlands) has research collaborations with Elekta AB, Stockholm, Sweden, Accuray Inc., Sunnyvale, CA, USA, Varian, Palo Alto, CA, USA, RaySearch Laboratories, Stockholm, Sweden, outside the submitted work. (© 2024 The Authors.)
Databáze:	MEDLINE
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