Benefit of particle therapy in re-irradiation of head and neck patients. Results of a multicentric in silico ROCOCO trial

Daniëlle B P Eekers, Erik Roelofs, Urszula Jelen, Maura Kirk, Marlies Granzier, Filippo Ammazzalorso, Peter H. Ahn, Geert O R J Janssens, Frank J P Hoebers, Tobias Friedmann, Timothy Solberg, Sean Walsh, Esther G C Troost, Johannes H A M Kaanders, Philippe Lambin

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background and Purpose: In this multicentric . in silico 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 silico 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.

Original languageEnglish (US)
JournalRadiotherapy and Oncology
DOIs
StateAccepted/In press - Nov 6 2015

Fingerprint

Proton Therapy
Computer Simulation
Organs at Risk
Neck
Head
Intensity-Modulated Radiotherapy
Ions
Photons
Therapeutics
Heavy Ion Radiotherapy
Brain Stem
Re-Irradiation
Protons
Neoplasms
Spinal Cord
Carbon

Keywords

  • Head and neck
  • In silico planning study
  • Multicentric trial
  • Particle therapy
  • Radiotherapy
  • Re-irradiation

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Benefit of particle therapy in re-irradiation of head and neck patients. Results of a multicentric in silico ROCOCO trial. / Eekers, Daniëlle B P; Roelofs, Erik; Jelen, Urszula; Kirk, Maura; Granzier, Marlies; Ammazzalorso, Filippo; Ahn, Peter H.; Janssens, Geert O R J; Hoebers, Frank J P; Friedmann, Tobias; Solberg, Timothy; Walsh, Sean; Troost, Esther G C; Kaanders, Johannes H A M; Lambin, Philippe.

In: Radiotherapy and Oncology, 06.11.2015.

Research output: Contribution to journalArticle

Eekers, DBP, Roelofs, E, Jelen, U, Kirk, M, Granzier, M, Ammazzalorso, F, Ahn, PH, Janssens, GORJ, Hoebers, FJP, Friedmann, T, Solberg, T, Walsh, S, Troost, EGC, Kaanders, JHAM & Lambin, P 2015, 'Benefit of particle therapy in re-irradiation of head and neck patients. Results of a multicentric in silico ROCOCO trial', Radiotherapy and Oncology. https://doi.org/10.1016/j.radonc.2016.08.020
Eekers, Daniëlle B P ; Roelofs, Erik ; Jelen, Urszula ; Kirk, Maura ; Granzier, Marlies ; Ammazzalorso, Filippo ; Ahn, Peter H. ; Janssens, Geert O R J ; Hoebers, Frank J P ; Friedmann, Tobias ; Solberg, Timothy ; Walsh, Sean ; Troost, Esther G C ; Kaanders, Johannes H A M ; Lambin, Philippe. / Benefit of particle therapy in re-irradiation of head and neck patients. Results of a multicentric in silico ROCOCO trial. In: Radiotherapy and Oncology. 2015.
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abstract = "Background and Purpose: In this multicentric . in silico 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 silico 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.",
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AU - Eekers, Daniëlle 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 - 2015/11/6

Y1 - 2015/11/6

N2 - Background and Purpose: In this multicentric . in silico 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 silico 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 silico 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 silico 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.

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KW - In silico planning study

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KW - Particle therapy

KW - Radiotherapy

KW - Re-irradiation

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