First experience with model-based selection of head and neck cancer patients for proton therapy
| Autor: | Hans Paul van der Laan, Johannes A. Langendijk, Tineke van Zon-Meijer, Makbule Tambas, Atje M Wolters, Johanna G M van den Hoek, Erik W Korevaar, Roel J H M Steenbakkers, Roel G J Kierkels, Stefan Both, E. Oldehinkel, D. Scandurra |
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| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Organs at Risk
medicine.medical_specialty TUBE-FEEDING DEPENDENCE medicine.medical_treatment Model-based selection Normal tissue 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Patient selection Advanced disease Humans Medicine Radiology Nuclear Medicine and imaging In patient Head and neck cancer OPTIMIZATION Proton therapy Selection (genetic algorithm) Netherlands RISK business.industry Radiotherapy Planning Computer-Assisted Radiotherapy Dosage Hematology medicine.disease 3. Good health Radiation therapy Oncology Head and Neck Neoplasms 030220 oncology & carcinogenesis Radiotherapy Intensity-Modulated Radiology business Complication RADIOTHERAPY |
| Zdroj: | Radiotherapy and Oncology, 151, 206-213. ELSEVIER IRELAND LTD Radiotherapy and Oncology |
| ISSN: | 1879-0887 0167-8140 |
| Popis: | PURPOSE: In the Netherlands, head and neck cancer (HNC) patients qualify for intensity modulated proton therapy (IMPT) based on model-based selection (MBS). The aim of this study was to evaluate the first experience in MBS of HNC patients.METHODS: Patients who were subjected to MBS (Jan 2018 - Sep 2019) were evaluated. A VMAT plan was created for all patients with optimal sparing of organ at risks (OARs) in normal tissue complication probability (NTCP) models for a number of toxicities. An IMPT plan was created only for those with NTCP difference (ΔNTCP) between VMAT and best-case scenario for proton (assuming 0 Gy dose for all OARs in IMPT plan) that exceeded any ΔNTCP-thresholds defined in Dutch National Indication Protocol. These patients qualified for a robust IMPT-plan creation with similar target doses and subsequent plan comparison.RESULTS: Of 227 patients, 141 (62%) qualified for plan comparison, of which 80 (35%) were eventually selected for proton therapy. Most patients were selected based on the ΔNTCP for dysphagia-related toxicities. The selection rate was higher among patients with advanced disease, pharyngeal tumors, and/or baseline complaints. A significant reduction in all OAR doses and NTCP values was obtained with IMPT compared with VMAT in both selected and non-selected patients, but more pronounced in patients selected for protons.CONCLUSION: Model-based selection of patients with HNC for proton therapy is clinically feasible. Approximately one third of HNC patients qualify for protons and these patients have the highest probability to benefit from protons in terms of toxicity prevention. |
| Databáze: | OpenAIRE |
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