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Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients

OBJECTIVE: To investigate the potential to reduce the cochlear dose with robotic photon radiosurgery or intensity-modulated proton therapy planning for vestibular schwannomas. MATERIALS AND METHODS: Clinically delivered photon radiosurgery treatment plans were compared to five cochlear-optimized pla...

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Autores principales: Koetsier, Kimberley S., Oud, Michelle, de Klerck, Erik, Hensen, Erik F, van Vulpen, Marco, van Linge, Anne, Paul van Benthem, Peter, Slagter, Cleo, Habraken, Steven J.M., Hoogeman, Mischa S., Méndez Romero, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585330/
https://www.ncbi.nlm.nih.gov/pubmed/37867612
http://dx.doi.org/10.1016/j.ctro.2023.100689
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author Koetsier, Kimberley S.
Oud, Michelle
de Klerck, Erik
Hensen, Erik F
van Vulpen, Marco
van Linge, Anne
Paul van Benthem, Peter
Slagter, Cleo
Habraken, Steven J.M.
Hoogeman, Mischa S.
Méndez Romero, A.
author_facet Koetsier, Kimberley S.
Oud, Michelle
de Klerck, Erik
Hensen, Erik F
van Vulpen, Marco
van Linge, Anne
Paul van Benthem, Peter
Slagter, Cleo
Habraken, Steven J.M.
Hoogeman, Mischa S.
Méndez Romero, A.
author_sort Koetsier, Kimberley S.
collection PubMed
description OBJECTIVE: To investigate the potential to reduce the cochlear dose with robotic photon radiosurgery or intensity-modulated proton therapy planning for vestibular schwannomas. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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spelling pubmed-105853302023-10-20 Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients Koetsier, Kimberley S. Oud, Michelle de Klerck, Erik Hensen, Erik F van Vulpen, Marco van Linge, Anne Paul van Benthem, Peter Slagter, Cleo Habraken, Steven J.M. Hoogeman, Mischa S. Méndez Romero, A. Clin Transl Radiat Oncol Original Research Article OBJECTIVE: To investigate the potential to reduce the cochlear dose with robotic photon radiosurgery or intensity-modulated proton therapy planning for vestibular schwannomas. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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. Elsevier 2023-10-07 /pmc/articles/PMC10585330/ /pubmed/37867612 http://dx.doi.org/10.1016/j.ctro.2023.100689 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Article
Koetsier, Kimberley S.
Oud, Michelle
de Klerck, Erik
Hensen, Erik F
van Vulpen, Marco
van Linge, Anne
Paul van Benthem, Peter
Slagter, Cleo
Habraken, Steven J.M.
Hoogeman, Mischa S.
Méndez Romero, A.
Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients
title Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients
title_full Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients
title_fullStr Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients
title_full_unstemmed Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients
title_short Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients
title_sort cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585330/
https://www.ncbi.nlm.nih.gov/pubmed/37867612
http://dx.doi.org/10.1016/j.ctro.2023.100689
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