Towards a Clinical Decision Support System for External Beam Radiation Oncology Prostate Cancer Patients

Autor: Andre Dekker, Philippe Lambin, Frank Verhaegen, Bleddyn Jones, Ben G. L. Vanneste, Erik Roelofs, Yvonka van Wijk, Sean Walsh, Dietmar Georg, Peter Kuess
Přispěvatelé: RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Radiotherapie, Promovendi ODB
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Cancer Research
medicine.medical_specialty
prostate cancer
radiotherapy
proton therapy
clinical decision support systems
in silico trial
radiobiological modelling
MOTION
Cost effectiveness
medicine.medical_treatment
Clinical decision support system
lcsh:RC254-282
THERAPY
Article
030218 nuclear medicine & medical imaging
COST-EFFECTIVENESS
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Prostate
PRECISION MEDICINE
medicine
COMPUTED-TOMOGRAPHY
Proton therapy
RANGE UNCERTAINTIES
Modality (human–computer interaction)
business.industry
LOCALIZATION
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
ULTRASOUND IMAGE GUIDANCE
Confidence interval
3. Good health
Radiation therapy
CELL-LUNG-CANCER
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
TRIAL
Radiology
business
Zdroj: Cancers
Cancers; Volume 10; Issue 2; Pages: 55
Cancers, Vol 10, Iss 2, p 55 (2018)
Cancers, 10(2):55. Multidisciplinary Digital Publishing Institute (MDPI)
ISSN: 2072-6694
Popis: We present a methodology which can be utilized to select proton or photon radiotherapy in prostate cancer patients. Four state-of-the-art competing treatment modalities were compared (by way of an in silico trial) for a cohort of 25 prostate cancer patients, with and without correction strategies for prostate displacements. Metrics measured from clinical image guidance systems were used. Three correction strategies were investigated; no-correction, extended-no-action-limit, and online-correction. Clinical efficacy was estimated via radiobiological models incorporating robustness (how probable a given treatment plan was delivered) and stability (the consistency between the probable best and worst delivered treatments at the 95% confidence limit). The results obtained at the cohort level enabled the determination of a threshold for likely clinical benefit at the individual level. Depending on the imaging system and correction strategy; 24%, 32% and 44% of patients were identified as suitable candidates for proton therapy. For the constraints of this study: Intensity-modulated proton therapy with online-correction was on average the most effective modality. Irrespective of the imaging system, each treatment modality is similar in terms of robustness, with and without the correction strategies. Conversely, there is substantial variation in stability between the treatment modalities, which is greatly reduced by correction strategies. This study provides a 'proof-of-concept' methodology to enable the prospective identification of individual patients that will most likely (above a certain threshold) benefit from proton therapy.
Databáze: OpenAIRE
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