TY - JOUR
T1 - Dosimetric comparison of five different techniques for craniospinal irradiation across 15 European centers
T2 - analysis on behalf of the SIOP-E-BTG (radiotherapy working group)
AU - Seravalli, Enrica
AU - Bosman, Mirjam
AU - Lassen-Ramshad, Yasmin
AU - Vestergaard, Anne
AU - Oldenburger, Foppe
AU - Visser, Jorrit
AU - Koutsouveli, Efi
AU - Paraskevopoulou, Chryssa
AU - Horan, Gail
AU - Ajithkumar, Thankamma
AU - Timmermann, Beate
AU - Fuentes, Carolina-Sofia
AU - Whitfield, Gillian
AU - Marchant, Thomas
AU - Padovani, Laetitia
AU - Garnier, Eloise
AU - Gandola, Lorenza
AU - Meroni, Silvia
AU - Hoeben, Bianca A W
AU - Kusters, Martijn
AU - Alapetite, Claire
AU - Losa, Sandra
AU - Goudjil, Farid
AU - Magelssen, Henriette
AU - Evensen, Morten Egeberg
AU - Saran, Frank
AU - Smyth, Gregory
AU - Rombi, Barbara
AU - Righetto, Roberto
AU - Kortmann, Rolf-Dieter
AU - Janssens, Geert O
N1 - Funding Information:
aDepartment of Radiation Oncology, University Medical Center Utrecht and Princess Maxima Centre for Pediatric Oncology, Utrecht, The Netherlands; bDepartment of Oncology and Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark; cDepartment of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands; dDepartment of Radiation Oncology, Hygeia Hospital, Athens, Greece; eDepartment of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; fClinic for Particle Therapy, West German Protontherapy Center Essen, University Hospital Essen, Essen, Germany; gThe University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK and The Children's Brain Tumour Research Network, University of Manchester, Royal Mancheste Children's Hospital, Manchester, UK; hThe Christie NHS Foundation Trust, Manchester, UK; iDepartment of Radiotherapy, Centre Hospitalier Universitaire de La Timone, Marseille, France; jPediatric Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy; kDepartment of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; lDepartment of Radiation Oncology, Institut Curie and Centre de protontherapie, Paris and Orsay, France; mDepartment of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway; nThe Royal Marsden NHS Foundation Trust, Sutton, UK; oJoint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK; pProtontherapy Center, Azienda Provinciale per i Servizi Sanitari APSS, Trento, Italy; qDepartment of Radiation Therapy, University Hospital Leipzig, Leipzig, Germany
Publisher Copyright:
© 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/9
Y1 - 2018/9
N2 - PURPOSE: Conventional techniques (3D-CRT) for craniospinal irradiation (CSI) are still widely used. Modern techniques (IMRT, VMAT, TomoTherapy®, proton pencil beam scanning [PBS]) are applied in a limited number of centers. For a 14-year-old patient, we aimed to compare dose distributions of five CSI techniques applied across Europe and generated according to the participating institute protocols, therefore representing daily practice.MATERIAL AND METHODS: A multicenter (n = 15) dosimetric analysis of five different techniques for CSI (3D-CRT, IMRT, VMAT, TomoTherapy®, PBS; 3 centers per technique) was performed using the same patient data, set of delineations and dose prescription (36.0/1.8 Gy). Different treatment plans were optimized based on the same planning target volume margin. All participating institutes returned their best treatment plan applicable in clinic.RESULTS: The modern radiotherapy techniques investigated resulted in superior conformity/homogeneity-indices (CI/HI), particularly in the spinal part of the target (CI: 3D-CRT:0.3 vs. modern:0.6; HI: 3D-CRT:0.2 vs. modern:0.1), and demonstrated a decreased dose to the thyroid, heart, esophagus and pancreas. Dose reductions of >10.0 Gy were observed with PBS compared to modern photon techniques for parotid glands, thyroid and pancreas. Following this technique, a wide range in dosimetry among centers using the same technique was observed (e.g., thyroid mean dose: VMAT: 5.6-24.6 Gy; PBS: 0.3-10.1 Gy).CONCLUSIONS: The investigated modern radiotherapy techniques demonstrate superior dosimetric results compared to 3D-CRT. The lowest mean dose for organs at risk is obtained with proton therapy. However, for a large number of organs ranges in mean doses were wide and overlapping between techniques making it difficult to recommend one radiotherapy technique over another.
AB - PURPOSE: Conventional techniques (3D-CRT) for craniospinal irradiation (CSI) are still widely used. Modern techniques (IMRT, VMAT, TomoTherapy®, proton pencil beam scanning [PBS]) are applied in a limited number of centers. For a 14-year-old patient, we aimed to compare dose distributions of five CSI techniques applied across Europe and generated according to the participating institute protocols, therefore representing daily practice.MATERIAL AND METHODS: A multicenter (n = 15) dosimetric analysis of five different techniques for CSI (3D-CRT, IMRT, VMAT, TomoTherapy®, PBS; 3 centers per technique) was performed using the same patient data, set of delineations and dose prescription (36.0/1.8 Gy). Different treatment plans were optimized based on the same planning target volume margin. All participating institutes returned their best treatment plan applicable in clinic.RESULTS: The modern radiotherapy techniques investigated resulted in superior conformity/homogeneity-indices (CI/HI), particularly in the spinal part of the target (CI: 3D-CRT:0.3 vs. modern:0.6; HI: 3D-CRT:0.2 vs. modern:0.1), and demonstrated a decreased dose to the thyroid, heart, esophagus and pancreas. Dose reductions of >10.0 Gy were observed with PBS compared to modern photon techniques for parotid glands, thyroid and pancreas. Following this technique, a wide range in dosimetry among centers using the same technique was observed (e.g., thyroid mean dose: VMAT: 5.6-24.6 Gy; PBS: 0.3-10.1 Gy).CONCLUSIONS: The investigated modern radiotherapy techniques demonstrate superior dosimetric results compared to 3D-CRT. The lowest mean dose for organs at risk is obtained with proton therapy. However, for a large number of organs ranges in mean doses were wide and overlapping between techniques making it difficult to recommend one radiotherapy technique over another.
UR - https://www.scopus.com/pages/publications/85046034560
U2 - 10.1080/0284186X.2018.1465588
DO - 10.1080/0284186X.2018.1465588
M3 - Article
C2 - 29698060
SN - 0284-186X
VL - 57
SP - 1240
EP - 1249
JO - Acta Oncologica
JF - Acta Oncologica
IS - 9
ER -