Treatment planning comparison in the PROTECT-trial randomising proton versus photon beam therapy in oesophageal cancer: Results from eight European centres

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  • Lone Hoffmann
  • Hanna Mortensen
  • Muhammad Shamshad
  • ,
  • Maaike Berbee, Maastricht University
  • ,
  • Nicola Bizzocchi, Paul Scherrer Institute
  • ,
  • Rebecca Bütof, Technische Universität Dresden
  • ,
  • Richard Canters, Maastricht University
  • ,
  • Gilles Defraene, KU Leuven
  • ,
  • Mai Lykkegaard Ehmsen
  • ,
  • Francesca Fiorini, Rutherford Cancer Centre Thames Valley
  • ,
  • Karin Haustermans, KU Leuven
  • ,
  • Ryan Hulley, Christie Hospital NHS Foundation Trust
  • ,
  • Erik W. Korevaar, University of Groningen
  • ,
  • Matthew Clarke, Christie Hospital NHS Foundation Trust
  • ,
  • Sebastian Makocki, Technische Universität Dresden
  • ,
  • Christina T. Muijs, University of Groningen
  • ,
  • Luke Murray, Rutherford Cancer Centre Thames Valley
  • ,
  • Owen Nicholas, South West Wales Cancer Institute and Swansea University College of Medicine
  • ,
  • Marianne Nordsmark
  • Ganesh Radhakrishna, Christie Hospital NHS Foundation Trust
  • ,
  • Melissa Thomas, KU Leuven
  • ,
  • Esther G.C. Troost, Helmholtz-Zentrum Dresden-Rossendorf, German Cancer Research Center, Technische Universität Dresden
  • ,
  • Gloria Vilches-Freixas, Maastricht University
  • ,
  • Sabine Visser, University of Groningen
  • ,
  • Damien C. Weber, Paul Scherrer Institute, University of Zurich
  • ,
  • Ditte Sloth Møller

Purpose: To compare dose distributions and robustness in treatment plans from eight European centres in preparation for the European randomized phase-III PROTECT-trial investigating the effect of proton therapy (PT) versus photon therapy (XT) for oesophageal cancer. Materials and methods: All centres optimized one PT and one XT nominal plan using delineated 4DCT scans for four patients receiving 50.4 Gy (RBE) in 28 fractions. Target volume receiving 95% of prescribed dose (V95%iCTVtotal) should be >99%. Robustness towards setup, range, and respiration was evaluated. The plans were recalculated on a surveillance 4DCT (sCT) acquired at fraction ten and robustness evaluation was performed to evaluate the effect of respiration and inter-fractional anatomical changes. Results: All PT and XT plans complied with V95%iCTVtotal >99% for the nominal plan and V95%iCTVtotal >97% for all respiratory and robustness scenarios. Lung and heart dose varied considerably between centres for both modalities. The difference in mean lung dose and mean heart dose between each pair of XT and PT plans was in median [range] 4.8 Gy [1.1;7.6] and 8.4 Gy [1.9;24.5], respectively. Patients B and C showed large inter-fractional anatomical changes on sCT. For patient B, the minimum V95%iCTVtotal in the worst-case robustness scenario was 45% and 94% for XT and PT, respectively. For patient C, the minimum V95%iCTVtotal was 57% and 72% for XT and PT, respectively. Patient A and D showed minor inter-fractional changes and the minimum V95%iCTVtotal was >85%. Conclusion: Large variability in dose to the lungs and heart was observed for both modalities. Inter-fractional anatomical changes led to larger target dose deterioration for XT than PT plans.

OriginalsprogEngelsk
TidsskriftRadiotherapy and Oncology
Vol/bind172
Sider (fra-til)32-41
Antal sider10
ISSN0167-8140
DOI
StatusUdgivet - jul. 2022

Bibliografisk note

Funding Information:
This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 101008134. The JU receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA. LH, MS and MN has received funding from Novo Nordisk Foundation grant No NNF19OC0057405, Denmark. GD is postdoctoral fellow of the Research Foundation Flanders (FWO, project 1292021N), Belgium. No.

Funding Information:
This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 101008134 . The JU receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA . LH, MS and MN has received funding from Novo Nordisk Foundation grant No NNF19OC0057405, Denmark. GD is postdoctoral fellow of the Research Foundation Flanders (FWO, project 1292021N ), Belgium.

Publisher Copyright:
© 2022 The Author(s)

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