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

doi:10.1016/j.radonc.2016.08.020

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

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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 (D₂) 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 language	English (US)
Pages (from-to)	387-394
Number of pages	8
Journal	Radiotherapy and Oncology
Volume	121
Issue number	3
DOIs	https://doi.org/10.1016/j.radonc.2016.08.020
State	Published - Dec 1 2016

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

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10.1016/j.radonc.2016.08.020

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Eekers, D. B. P., Roelofs, E., Jelen, U., Kirk, M., Granzier, M., Ammazzalorso, F., Ahn, P. H., Janssens, G. O. R. J., Hoebers, F. J. P., Friedmann, T., Solberg, T., Walsh, S., Troost, E. G. C., Kaanders, J. H. A. M., & Lambin, P. (2016). Benefit of particle therapy in re-irradiation of head and neck patients. Results of a multicentric in silico ROCOCO trial. Radiotherapy and Oncology, 121(3), 387-394. https://doi.org/10.1016/j.radonc.2016.08.020

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 2016, 'Benefit of particle therapy in re-irradiation of head and neck patients. Results of a multicentric in silico ROCOCO trial', Radiotherapy and Oncology, vol. 121, no. 3, pp. 387-394. https://doi.org/10.1016/j.radonc.2016.08.020

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

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 (D2) 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.",

keywords = "Head and neck, In silico planning study, Multicentric trial, Particle therapy, Radiotherapy, Re-irradiation",

author = "Eekers, {Dani{\"e}lle B P} and Erik Roelofs and Urszula Jelen and Maura Kirk and Marlies Granzier and Filippo Ammazzalorso and Ahn, {Peter H.} and Janssens, {Geert O R J} and Hoebers, {Frank J P} and Tobias Friedmann and Timothy Solberg and Sean Walsh and Troost, {Esther G C} and Kaanders, {Johannes H A M} and Philippe Lambin",

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year = "2016",

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doi = "10.1016/j.radonc.2016.08.020",

language = "English (US)",

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T1 - Benefit of particle therapy in re-irradiation of head and neck patients. Results of a multicentric in silico ROCOCO trial

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 - 2016/12/1

Y1 - 2016/12/1

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 (D2) 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 (D2) 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.

KW - Head and neck

KW - In silico planning study

KW - Multicentric trial

KW - Particle therapy

KW - Radiotherapy

KW - Re-irradiation

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DO - 10.1016/j.radonc.2016.08.020

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AN - SCOPUS:84994845840

SN - 0167-8140

VL - 121

SP - 387

EP - 394

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

IS - 3

ER -

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

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