TY - JOUR
T1 - Harmonization of proton treatment planning for head and neck cancer using pencil beam scanning
T2 - first report of the IPACS collaboration group
AU - Stock, Markus
AU - Gora, Joanna
AU - Perpar, Ana
AU - Georg, Petra
AU - Lehde, Alexander
AU - Kragl, Gabriele
AU - Hug, Eugen
AU - Vondracek, Vladimir
AU - Kubes, Jiri
AU - Poulova, Zuzana
AU - Algranati, Carlo
AU - Cianchetti, Marco
AU - Schwarz, Marco
AU - Amichetti, Maurizio
AU - Kajdrowicz, Tomasz
AU - Kopeć, Renata
AU - Mierzwińska, Gabriela
AU - Olko, Paweł
AU - Skowrońska, Katarzyna
AU - Sowa, Urszula
AU - Góra, Eleonora
AU - Kisielewicz, Kamil
AU - Sas-Korczyńska, Beata
AU - Skóra, Tomasz
AU - Bäck, Anna
AU - Gustafsson, Magnus
AU - Sooaru, Maret
AU - Witt Nyström, Petra
AU - Nyman, Jan
AU - Björk Eriksson, Thomas
N1 - Publisher Copyright:
© 2019, © 2019 Acta Oncologica Foundation.
PY - 2019/12/2
Y1 - 2019/12/2
N2 - Background and purpose: A collaborative network between proton therapy (PT) centres in Trento in Italy, Poland, Austria, Czech Republic and Sweden (IPACS) was founded to implement trials and harmonize PT. This is the first report of IPACS with the aim to show the level of harmonization that can be achieved for proton therapy planning of head and neck (sino-nasal) cancer.Methods: CT-data sets of five patients were included. During several face-to-face and online meetings, a common treatment planning protocol was developed. Each centre used its own treatment planning system (TPS) and planning approach with some restrictions specified in the treatment planning protocol. In addition, volumetric modulated arc therapy (VMAT) photon plans were created.Results: For CTV1, the average Dmedian was 59.3 ± 2.4 Gy(RBE) for protons and 58.8 ± 2.0 Gy(RBE) for VMAT (aim was 56 Gy(RBE)). For CTV2, the average Dmedian was 71.2 ± 1.0 Gy(RBE) for protons and 70.6 ± 0.4 Gy(RBE) for VMAT (aim was 70 Gy(RBE)). The average D2% for the spinal cord was 25.1 ± 8.5 Gy(RBE) for protons and 47.6 ± 1.4 Gy(RBE) for VMAT. The average D2% for chiasm was 46.5 ± 4.4 Gy(RBE) for protons and 50.8 ± 1.4 Gy(RBE) for VMAT, respectively. Robust evaluation was performed and showed the least robust plans for plans with a low number of beams.Discussion: In conclusion, several influences on harmonization were identified: adherence/interpretation to/of the protocol, available technology, experience in treatment planning and use of different beam arrangements. In future, all OARs that should be included in the optimization need to be specified in order to further harmonize treatment planning.
AB - Background and purpose: A collaborative network between proton therapy (PT) centres in Trento in Italy, Poland, Austria, Czech Republic and Sweden (IPACS) was founded to implement trials and harmonize PT. This is the first report of IPACS with the aim to show the level of harmonization that can be achieved for proton therapy planning of head and neck (sino-nasal) cancer.Methods: CT-data sets of five patients were included. During several face-to-face and online meetings, a common treatment planning protocol was developed. Each centre used its own treatment planning system (TPS) and planning approach with some restrictions specified in the treatment planning protocol. In addition, volumetric modulated arc therapy (VMAT) photon plans were created.Results: For CTV1, the average Dmedian was 59.3 ± 2.4 Gy(RBE) for protons and 58.8 ± 2.0 Gy(RBE) for VMAT (aim was 56 Gy(RBE)). For CTV2, the average Dmedian was 71.2 ± 1.0 Gy(RBE) for protons and 70.6 ± 0.4 Gy(RBE) for VMAT (aim was 70 Gy(RBE)). The average D2% for the spinal cord was 25.1 ± 8.5 Gy(RBE) for protons and 47.6 ± 1.4 Gy(RBE) for VMAT. The average D2% for chiasm was 46.5 ± 4.4 Gy(RBE) for protons and 50.8 ± 1.4 Gy(RBE) for VMAT, respectively. Robust evaluation was performed and showed the least robust plans for plans with a low number of beams.Discussion: In conclusion, several influences on harmonization were identified: adherence/interpretation to/of the protocol, available technology, experience in treatment planning and use of different beam arrangements. In future, all OARs that should be included in the optimization need to be specified in order to further harmonize treatment planning.
KW - Brain Stem/radiation effects
KW - Cochlea/radiation effects
KW - Europe
KW - Head and Neck Neoplasms/diagnostic imaging
KW - Humans
KW - International Cooperation
KW - Larynx/radiation effects
KW - Nose Neoplasms/diagnostic imaging
KW - Optic Nerve/radiation effects
KW - Organs at Risk/radiation effects
KW - Paranasal Sinus Neoplasms/diagnostic imaging
KW - Parotid Gland/radiation effects
KW - Photons/therapeutic use
KW - Proton Therapy/methods
KW - Radiotherapy Planning, Computer-Assisted/methods
KW - Radiotherapy, Intensity-Modulated/methods
KW - Tomography, X-Ray Computed
KW - Tumor Burden
UR - http://www.scopus.com/inward/record.url?scp=85070843004&partnerID=8YFLogxK
U2 - 10.1080/0284186X.2019.1648858
DO - 10.1080/0284186X.2019.1648858
M3 - Journal article
C2 - 31393203
SN - 0284-186X
VL - 58
SP - 1720
EP - 1730
JO - Acta Oncologica
JF - Acta Oncologica
IS - 12
ER -