Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy.
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Toussaint Laura, Matysiak Witold, Alapetite Claire, Aristu Javier, Bannink-Gawryszuk Agata, Bolle Stephanie, Bolsi Alessandra, Calvo Felipe, Cerron Campoo Fernando, Charlwood Frances, Demoor-Goldschmidt Charlotte, Doyen Jérôme, Drosik-Rutowicz Katarzyna, Dutheil Pauline, Embring Anna, Engellau Jacob, Goedgebeur Anneleen, Goudjil Farid, Harrabi Semi, Kopec Renata, Kristensen Ingrid, Lægsdmand Peter, Lütgendorf-Caucig Carola, Meijers Arturs, Mirandola Alfredo, Missohou Fernand, Montero Feijoo Marta, Muren Ludvig P, Ondrova Barbora, Orlandi Ester, Pettersson Erik, Pica Alessia, Plaude Sandija, Righetto Roberto, Rombi Barbara, Timmermann Beate, Van Beek Karen, Vela Anthony, Vennarini Sabina, Vestergaard Anne, Vidal Marie, Vondracek Vladimir, Weber Damien C, Whitfield Gillian, Zimmerman Jens, Maduro John H, Lassen-Ramshad Yasmin
Аннотация
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.