Intensity-modulated proton therapy decreases dose to organs at risk in low-grade glioma patients: results of a multicentric in silico ROCOCO trial

Danielle B. P. Eekers*, Erik Roelofs, Macarena Cubillos-Mesias, Charles Niel, Robert Jan Smeenk, Ann Hoeben, Andre W. H. Minken, Marlies Granzier, Geert O. Janssens, Johannes H. A. M. Kaanders, Philippe Lambin, Esther G. C. Troost

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background and purpose: Patients with low-grade glioma (LGG) have a prolonged survival expectancy due to better discriminative tumor classification and multimodal treatment. Consequently, long-term treatment toxicity gains importance. Contemporary radiotherapy techniques such as intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), tomotherapy (TOMO) and intensity-modulated proton therapy (IMPT) enable high-dose irradiation of the target but they differ regarding delivered dose to organs at risk (OARs). The aim of this comparative in silico study was to determine these dosimetric differences in delivered doses.Material and methods: Imaging datasets of 25 LGG patients having undergone postoperative radiotherapy were included. For each of these patients, in silico treatment plans to a total dose of 50.4Gy to the target volume were generated for the four treatment modalities investigated (i.e., IMRT, VMAT, TOMO, IMPT). Resulting treatment plans were analyzed regarding dose to target and surrounding OARs comparing IMRT, TOMO and IMPT to VMAT.Results: In total, 100 treatment plans (four per patient) were analyzed. Compared to VMAT, the IMPT mean dose (D-mean) for nine out of 10 (90%) OARs was statistically significantly (p

Original languageEnglish
Pages (from-to)57-65
Number of pages9
JournalActa Oncologica
Volume58
Issue number1
DOIs
Publication statusPublished - 2019

Keywords

  • HELICAL TOMOTHERAPY
  • BEAM THERAPY
  • ARC THERAPY
  • RADIOTHERAPY
  • RADIATION
  • CANCER
  • HEAD
  • PHOTONS
  • IMPACT
  • RANGE

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