NRG Oncology White Paper on the Relative Biological Effectiveness in Proton Therapy.

Autor:	Paganetti H; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts; Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts., Simone CB 2nd; New York Proton Center, New York, New York; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York., Bosch WR; Department of Radiation Oncology, Washington University, St. Louis, Missouri., Haas-Kogan D; Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts; Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston Children's Hospital, Boston, Massachusetts., Kirsch DG; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada., Li H; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland., Liang X; Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida., Liu W; Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona., Mahajan A; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota., Story MD; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas., Taylor PA; UT MD Anderson Cancer Center, Houston, Texas., Willers H; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts; Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts., Xiao Y; Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania., Buchsbaum JC; National Cancer Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: jeff.buchsbaum@nih.gov.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2025 Jan 01; Vol. 121 (1), pp. 202-217. Date of Electronic Publication: 2024 Jul 25.
DOI:	10.1016/j.ijrobp.2024.07.2152
Abstrakt:	This position paper, led by the NRG Oncology Particle Therapy Work Group, focuses on the concept of relative biologic effect (RBE) in clinical proton therapy (PT), with the goal of providing recommendations for the next-generation clinical trials with PT on the best practice of investigating and using RBE, which could deviate from the current standard proton RBE value of 1.1 relative to photons. In part 1, current clinical utilization and practice are reviewed, giving the context and history of RBE. Evidence for variation in RBE is presented along with the concept of linear energy transfer (LET). The intertwined nature of tumor radiobiology, normal tissue constraints, and treatment planning with LET and RBE considerations is then reviewed. Part 2 summarizes current and past clinical data and then suggests the next steps to explore and employ tools for improved dynamic models for RBE. In part 3, approaches and methods for the next generation of prospective clinical trials are explored, with the goal of optimizing RBE to be both more reflective of clinical reality and also deployable in trials to allow clinical validation and interpatient comparisons. These concepts provide the foundation for personalized biologic treatments reviewed in part 4. Finally, we conclude with a summary including short- and long-term scientific focus points for clinical PT. The practicalities and capacity to use RBE in treatment planning are reviewed and considered with more biological data in hand. The intermediate step of LET optimization is summarized and proposed as a potential bridge to the ultimate goal of case-specific RBE planning that can be achieved as a hypothesis-generating tool in near-term proton trials. (Published by Elsevier Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu