Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients.
Cochlea
Hearing disorders
Proton therapy
Radiosurgery
Vestibular schwannoma
Journal
Clinical and translational radiation oncology
ISSN: 2405-6308
Titre abrégé: Clin Transl Radiat Oncol
Pays: Ireland
ID NLM: 101713416
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
05
07
2023
revised:
05
10
2023
accepted:
05
10
2023
medline:
23
10
2023
pubmed:
23
10
2023
entrez:
23
10
2023
Statut:
epublish
Résumé
To investigate the potential to reduce the cochlear dose with robotic photon radiosurgery or intensity-modulated proton therapy planning for vestibular schwannomas. Clinically delivered photon radiosurgery treatment plans were compared to five cochlear-optimized plans: one photon and four proton plans (total of 120). A 1x12 Gy dose was prescribed. Photon plans were generated with Precision (Cyberknife, Accuray) with no PTV margin for set-up errors. Proton plans were generated using an in-house automated multi-criterial planning system with three or nine-beam arrangements, and applying 0 or 3 mm robustness for set-up errors during plan optimization and evaluation (and 3 % range robustness). The sample size was calculated based on a reduction of cochlear Dmean > 1.5 Gy(RBE) from the clinical plans, and resulted in 24 patients. Compared to the clinical photon plans, a reduction of cochlear Dmean > 1.5 Gy(RBE) could be achieved in 11/24 cochlear-optimized photon plans, 4/24 and 6/24 cochlear-optimized proton plans without set-up robustness for three and nine-beam arrangement, respectively, and in 0/24 proton plans with set-up robustness. The cochlea could best be spared in cases with a distance between tumor and cochlea. Using nine proton beams resulted in a reduced dose to most organs at risk. Cochlear dose reduction is possible in vestibular schwannoma radiosurgery while maintaining tumor coverage, especially when the tumor is not adjacent to the cochlea. With current set-up robustness, proton therapy is capable of providing lower dose to organs at risk located distant to the tumor, but not for organs adjacent to it. Consequently, photon plans provided better cochlear sparing than proton plans.
Identifiants
pubmed: 37867612
doi: 10.1016/j.ctro.2023.100689
pii: S2405-6308(23)00114-3
pmc: PMC10585330
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100689Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dr. Hoogeman reports grants from Varian Medical Systems Particle Therapy GmbH & Co. KG, Troisdorf, Germany, during the conduct of the study; membership of advisory board Accuray, Sunnyvale, USA and participant/presenter Accuray Thinktank Meeting, outside the submitted work; and The Department of Radiotherapy (Erasmus Medical Center Cancer Institute, The Netherlands) has research collaborations with Elekta AB, Stockholm, Sweden, Accuray Inc., Sunnyvale, CA, USA, Varian, Palo Alto, CA, USA, RaySearch Laboratories, Stockholm, Sweden, outside the submitted work].
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