Scientific publications
Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy. Scientific Publication
Laura Toussaint 1 , Witold Matysiak 2 , Claire Alapetite 3 , Javier Aristu 4 , Agata Bannink-Gawryszuk 2 , Stephanie Bolle 5 , Alessandra Bolsi 6 , Felipe Calvo 4 , Fernando Cerron Campoo 7 , Frances Charlwood 8 , Charlotte Demoor-Goldschmidt 9 , Jérôme Doyen 10 , Katarzyna Drosik-Rutowicz 11 , Pauline Dutheil 12 , Anna Embring 13 , Jacob Engellau 14 , Anneleen Goedgebeur 15 , Farid Goudjil 3 , Semi Harrabi 16 , Renata Kopec 17 , Ingrid Kristensen 14 , Peter Lægsdmand 18 , Carola Lütgendorf-Caucig 19 , Arturs Meijers 6 , Alfredo Mirandola 20 , Fernand Missohou 12 , Marta Montero Feijoo 7 , Ludvig P Muren 18 , Barbora Ondrova 21 , Ester Orlandi 22 , Erik Pettersson 23 , Alessia Pica 6 , Sandija Plaude 24 , Roberto Righetto 25 , Barbara Rombi 26 , Beate Timmermann 27 , Karen Van Beek 15 , Anthony Vela 12 , Sabina Vennarini 28 , Anne Vestergaard 29 , Marie Vidal 10 , Vladimir Vondracek 21 , Damien C Weber 6 , Gillian Whitfield 30 , Jens Zimmerman 31 , John H Maduro 2 , Yasmin Lassen-Ramshad 29
Background and purpose: As no guidelines for pencil beam scanning (PBS) proton therapy (PT) of paediatric posterior fossa (PF) tumours exist to date, this study investigated planning techniques across European PT centres, with special considerations for brainstem and spinal cord sparing.
Materials and methods: A survey and a treatment planning comparison were initiated across nineteen European PBS-PT centres treating paediatric patients. The survey assessed all aspects of the treatment chain, including but not limited to delineations, dose constraints and treatment planning. Each centre planned two PF tumour cases for focal irradiation, according to their own clinical practice but based on common delineations. The prescription dose was 54 Gy(RBE) for Case 1 and 59.4 Gy(RBE) for Case 2. For both cases, planning strategies and relevant dose metrics were compared.
Results: Seventeen (89 %) centres answered the survey, and sixteen (80 %) participated in the treatment planning comparison. In the survey, thirteen (68 %) centres reported using the European Particle Therapy Network definition for brainstem delineation. In the treatment planning study, while most centres used three beam directions, their configurations varied widely across centres. Large variations were also seen in brainstem doses, with a brainstem near maximum dose (D2%) ranging from 52.7 Gy(RBE) to 55.7 Gy(RBE) (Case 1), and from 56.8 Gy(RBE) to 60.9 Gy(RBE) (Case 2).
Conclusion: This study assessed the European PBS-PT planning of paediatric PF tumours. Agreement was achieved in e.g. delineation-practice, while wider variations were observed in planning approach and consequently dose to organs at risk. Collaboration between centres is still ongoing, striving towards common guidelines.
CITATION Radiother Oncol. 2024 Jun 26:198:110414. doi: 10.1016/j.radonc.2024.110414
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