Variations in linear energy transfer distributions within a European proton therapy planning comparison of paediatric posterior fossa tumours

IF 3.4 Q2 ONCOLOGY

Physics and Imaging in Radiation Oncology Pub Date : 2024-10-01 DOI:10.1016/j.phro.2024.100675

Peter Lægdsmand , Witold Matysiak , Ludvig P. Muren , Yasmin Lassen-Ramshad , John H. Maduro , Anne Vestergaard , Roberto Righetto , Erik Pettersson , Ingrid Kristensen , Pauline Dutheil , Charlotte Demoor-Goldschmidt , Frances Charlwood , Gillian Whitfield , Marta M. Feijoo , Anthony Vela , Fernand Missohou , Sabina Vennarini , Alfredo Mirandola , Ester Orlandi , Barbara Rombi , Laura Toussaint

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Abstract

Background and Purpose

Radiotherapy for paediatric posterior fossa tumours may cause complications in the brainstem and upper spinal cord due to high doses. With proton therapy (PT) this risk may increase due to higher relative biological effectiveness (RBE) from elevated linear energy transfer (LET). This study assesses variations in LET in the brainstem and spinal cord in proton treatment plans from European centres.

Materials and Methods

Ten European PT centres using spot-scanning PT planned two paediatric posterior fossa cases: One overlapping partly with the brainstem and upper spinal cord, prescribed 54 Gy(RBE), and the second wrapping around these organs, prescribed 59.4 Gy(RBE). Dose-averaged LET distributions were assessed in volumes of the brainstem and spinal cord irradiated to over 50 Gy(RBE = 1.1). The maximum hinge angle effect on near-maximum RBE-weighted doses using the Unkelbach RBE model was also investigated.

Results

In the first case, the mean LET in brainstem volumes receiving more than 50 Gy(RBE = 1.1) ranged from 2.8 keV/µm to 3.6 keV/µm across centres (median: 3.3 keV/µm). In the second case, treatment plans showed a narrower range of mean LET in the brainstem, from 2.5 keV/µm to 2.8 keV/µm (median: 2.7 keV/µm). There was no statistically significant impact of the maximum hinge angle.

Conclusions

LET distributions vary across centres due to different techniques but are also influenced significantly by factors like shape and position of the target volume.

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欧洲儿科后窝肿瘤质子治疗规划比较中的线性能量传递分布差异

背景和目的小儿后窝肿瘤的放射治疗可能会因剂量过高而引起脑干和脊髓上部的并发症。使用质子疗法（PT）时，由于线性能量转移（LET）升高导致相对生物效应（RBE）升高，这种风险可能会增加。本研究评估了欧洲质子治疗中心质子治疗计划中脑干和脊髓LET的变化：其中一个病例与脑干和脊髓上部部分重叠，治疗剂量为 54 Gy(RBE)，另一个病例围绕这些器官，治疗剂量为 59.4 Gy(RBE)。评估了脑干和脊髓体积的剂量平均 LET 分布，辐照剂量超过 50 Gy（RBE = 1.1）。结果在第一个病例中，各中心接受 50 Gy 以上（RBE = 1.1）照射的脑干体积的平均 LET 为 2.8 keV/µm 至 3.6 keV/µm（中位数：3.3 keV/µm）。在第二个病例中，治疗计划显示脑干的平均 LET 范围较窄，从 2.5 keV/µm 到 2.8 keV/µm（中位数：2.7 keV/µm）。最大铰链角在统计学上没有显著影响。结论LET的分布因不同中心的技术而异，但也受到靶体积的形状和位置等因素的显著影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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