TY - JOUR
T1 - Benefit of particle therapy in re-irradiation of head and neck patients. Results of a multicentric in silico ROCOCO trial
AU - Eekers, Danielle B. P.
AU - Roelofs, Erik
AU - Jelen, Urszula
AU - Kirk, Maura
AU - Granzier, Marlies
AU - Ammazzalorso, Filippo
AU - Ahn, Peter H.
AU - Janssens, Geert O. R. J.
AU - Hoebers, Frank J. P.
AU - Friedmann, Tobias
AU - Solberg, Timothy
AU - Walsh, Sean
AU - Troost, Esther G. C.
AU - Kaanders, Johannes H. A. M.
AU - Lambin, Philippe
PY - 2016/12
Y1 - 2016/12
N2 - Background and Purpose: In this multicentric in silica trial we compared photon, proton, and carbon-ion radiotherapy plans for re-irradiation of patients with squamous cell carcinoma of the head and neck (HNSCC) regarding dose to tumour and doses to surrounding organs at risk (OARS). Material and Methods: Twenty-five HNSCC patients with a second new or recurrent cancer after previous irradiation (70 Gy) were included. Intensity-modulated proton therapy (IMPT) and ion therapy (IMIT) re irradiation plans to a second subsequent dose of 70 Gy were compared to photon therapy delivered with volumetric modulated arc therapy (VMAT). Results: When comparing IMIT and IMPT to VMAT, the mean dose to all investigated 22 OARs was significantly reduced for IMIT and to 15 out of 22 OARs (68%) using IMPT. The maximum dose to 2% volume (D-2) of the brainstem and spinal cord were significantly reduced using IMPT and IMIT compared to VMAT. The data are available on www.cancerdata.org. Conclusions: In this ROCOCO in silica trial, a reduction in mean dose to OARs was achieved using particle therapy compared to photons in the re-irradiation of HNSCC. There was a dosimetric benefit favouring carbon-ions above proton therapy. These dose reductions may potentially translate into lower severe complication rates related to the re-irradiation.
AB - Background and Purpose: In this multicentric in silica trial we compared photon, proton, and carbon-ion radiotherapy plans for re-irradiation of patients with squamous cell carcinoma of the head and neck (HNSCC) regarding dose to tumour and doses to surrounding organs at risk (OARS). Material and Methods: Twenty-five HNSCC patients with a second new or recurrent cancer after previous irradiation (70 Gy) were included. Intensity-modulated proton therapy (IMPT) and ion therapy (IMIT) re irradiation plans to a second subsequent dose of 70 Gy were compared to photon therapy delivered with volumetric modulated arc therapy (VMAT). Results: When comparing IMIT and IMPT to VMAT, the mean dose to all investigated 22 OARs was significantly reduced for IMIT and to 15 out of 22 OARs (68%) using IMPT. The maximum dose to 2% volume (D-2) of the brainstem and spinal cord were significantly reduced using IMPT and IMIT compared to VMAT. The data are available on www.cancerdata.org. Conclusions: In this ROCOCO in silica trial, a reduction in mean dose to OARs was achieved using particle therapy compared to photons in the re-irradiation of HNSCC. There was a dosimetric benefit favouring carbon-ions above proton therapy. These dose reductions may potentially translate into lower severe complication rates related to the re-irradiation.
KW - In silico planning study
KW - Head and neck
KW - Re-irradiation
KW - Multicentric trial
KW - Radiotherapy
KW - Particle therapy
U2 - 10.1016/j.radonc.2016.08.020
DO - 10.1016/j.radonc.2016.08.020
M3 - Article
C2 - 27639891
SN - 0167-8140
VL - 121
SP - 387
EP - 394
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 3
ER -