Harmonization of proton treatment planning for head and neck cancer using pencil beam scanning: first report of the IPACS collaboration group

Authors

  • Markus Stock MedAustron Ion Therapy Centre, Wiener Neustadt, Austria
  • Joanna Gora MedAustron Ion Therapy Centre, Wiener Neustadt, Austria
  • Ana Perpar MedAustron Ion Therapy Centre, Wiener Neustadt, Austria
  • Petra Georg MedAustron Ion Therapy Centre, Wiener Neustadt, Austria
  • Alexander Lehde MedAustron Ion Therapy Centre, Wiener Neustadt, Austria
  • Gabriele Kragl MedAustron Ion Therapy Centre, Wiener Neustadt, Austria
  • Eugen Hug MedAustron Ion Therapy Centre, Wiener Neustadt, Austria
  • Vladimir Vondracek Proton Therapy Centre Czech, Medical Physics, Prague, Czechia
  • Jiri Kubes Proton Therapy Centre Czech, Radiation Oncology, Prague, Czechia
  • Zuzana Poulova Proton Therapy Centre Czech, Medical Physics, Prague, Czechia
  • Carlo Algranati U.O. di Protonterapia- Azienda Provinciale per I Servizi Sanitari Trento, Trento, Italy
  • Marco Cianchetti U.O. di Protonterapia- Azienda Provinciale per I Servizi Sanitari Trento, Trento, Italy
  • Marco Schwarz U.O. di Protonterapia- Azienda Provinciale per I Servizi Sanitari Trento, Trento, Italy
  • Maurizio Amichetti U.O. di Protonterapia- Azienda Provinciale per I Servizi Sanitari Trento, Trento, Italy
  • Tomasz Kajdrowicz Institute of Nuclear Physics Polish Academy of Sciences, Cyclotron Centre Bronowice, Kraków, Poland
  • Renata Kopeć Institute of Nuclear Physics Polish Academy of Sciences, Cyclotron Centre Bronowice, Kraków, Poland
  • Gabriela Mierzwińska Institute of Nuclear Physics Polish Academy of Sciences, Cyclotron Centre Bronowice, Kraków, Poland
  • Paweł Olko Institute of Nuclear Physics Polish Academy of Sciences, Cyclotron Centre Bronowice, Kraków, Poland
  • Katarzyna Skowrońska Institute of Nuclear Physics Polish Academy of Sciences, Cyclotron Centre Bronowice, Kraków, Poland
  • Urszula Sowa Institute of Nuclear Physics Polish Academy of Sciences, Cyclotron Centre Bronowice, Kraków, Poland
  • Eleonora Góra Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Radiation Oncology, Kraków, Poland
  • Kamil Kisielewicz Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Radiation Oncology, Kraków, Poland
  • Beata Sas-Korczyńska Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Radiation Oncology, Kraków, Poland
  • Tomasz Skóra Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Radiation Oncology, Kraków, Poland
  • Anna Bäck The Skandion Clinic, Uppsala, Sweden; Department of Therapeutic Radiation Physics, Sahlgrenska University Hospital, Göteborg, Sweden; Department of Radiation Physics, University of Gothenburg, Göteborg, Sweden
  • Magnus Gustafsson The Skandion Clinic, Uppsala, Sweden; Department of Therapeutic Radiation Physics, Sahlgrenska University Hospital, Göteborg, Sweden
  • Maret Sooaru The Skandion Clinic, Uppsala, Sweden; Department of Therapeutic Radiation Physics, Sahlgrenska University Hospital, Göteborg, Sweden
  • Petra Witt Nyström The Skandion Clinic, Uppsala, Sweden; Danish Centre for Particle Therapy, Aarhus, Denmark
  • Jan Nyman Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Thomas Björk Eriksson The Skandion Clinic, Uppsala, Sweden; Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden; Regional Cancer Center West, Göteborg, Sweden

DOI:

https://doi.org/10.1080/0284186X.2019.1648858

Abstract

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.

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Published

2019-12-02

How to Cite

Stock, M., Gora, J., Perpar, A., Georg, P., Lehde, A., Kragl, G., … Björk Eriksson, T. (2019). Harmonization of proton treatment planning for head and neck cancer using pencil beam scanning: first report of the IPACS collaboration group. Acta Oncologica, 58(12), 1720–1730. https://doi.org/10.1080/0284186X.2019.1648858

Issue

Vol. 58 No. 12 (2019): Acta Oncologica

Section

Articles