Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy

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

doi:10.1016/j.radonc.2024.110414

Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

Original language	English
Article number	110414
Number of pages	8
Journal	Radiotherapy and Oncology
Volume	198
DOIs	https://doi.org/10.1016/j.radonc.2024.110414
Publication status	Published - Sept-2024

Keywords

Humans
Proton Therapy/methods
Infratentorial Neoplasms/radiotherapy
Europe
Child
Radiotherapy Planning, Computer-Assisted/methods
Radiotherapy Dosage
Child, Preschool
Male
Female
Organs at Risk/radiation effects
Brain Stem/radiation effects

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Toussaint, L., Matysiak, W., Alapetite, C., Aristu, J., Bannink-Gawryszuk, A., Bolle, S., Bolsi, A., Calvo, F., Cerron Campoo, F., Charlwood, F., Demoor-Goldschmidt, C., Doyen, J., Drosik-Rutowicz, K., Dutheil, P., Embring, A., Engellau, J., Goedgebeur, A., Goudjil, F., Harrabi, S., ... Lassen-Ramshad, Y. (2024). Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy. Radiotherapy and Oncology, 198, Article 110414. https://doi.org/10.1016/j.radonc.2024.110414

@article{d38b7b9b95204564909955999119e4a1,

title = "Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy",

abstract = "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.",

keywords = "Humans, Proton Therapy/methods, Infratentorial Neoplasms/radiotherapy, Europe, Child, Radiotherapy Planning, Computer-Assisted/methods, Radiotherapy Dosage, Child, Preschool, Male, Female, Organs at Risk/radiation effects, Brain Stem/radiation effects",

author = "Laura Toussaint and Witold Matysiak and Claire Alapetite and Javier Aristu and Agata Bannink-Gawryszuk and Stephanie Bolle and Alessandra Bolsi and Felipe Calvo and {Cerron Campoo}, Fernando and Frances Charlwood and Charlotte Demoor-Goldschmidt and J{\'e}r{\^o}me Doyen and Katarzyna Drosik-Rutowicz and Pauline Dutheil and Anna Embring and Jacob Engellau and Anneleen Goedgebeur and Farid Goudjil and Semi Harrabi and Renata Kopec and Ingrid Kristensen and Peter L{\ae}gsdmand and Carola L{\"u}tgendorf-Caucig and Arturs Meijers and Alfredo Mirandola and Fernand Missohou and {Montero Feijoo}, Marta and Muren, {Ludvig P} and Barbora Ondrova and Ester Orlandi and Erik Pettersson and Alessia Pica and Sandija Plaude and Roberto Righetto and Barbara Rombi and Beate Timmermann and {Van Beek}, Karen and Anthony Vela and Sabina Vennarini and Anne Vestergaard and Marie Vidal and Vladimir Vondracek and Weber, {Damien C} and Gillian Whitfield and Jens Zimmerman and Maduro, {John H} and Yasmin Lassen-Ramshad",

year = "2024",

month = sep,

doi = "10.1016/j.radonc.2024.110414",

language = "English",

volume = "198",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "ELSEVIER IRELAND LTD",

}

Toussaint, L, Matysiak, W, Alapetite, C, Aristu, J, Bannink-Gawryszuk, A, Bolle, S, Bolsi, A, Calvo, F, Cerron Campoo, F, Charlwood, F, Demoor-Goldschmidt, C, Doyen, J, Drosik-Rutowicz, K, Dutheil, P, Embring, A, Engellau, J, Goedgebeur, A, Goudjil, F, Harrabi, S, Kopec, R, Kristensen, I, Lægsdmand, P, Lütgendorf-Caucig, C, Meijers, A, Mirandola, A, Missohou, F, Montero Feijoo, M, Muren, LP, Ondrova, B, Orlandi, E, Pettersson, E, Pica, A, Plaude, S, Righetto, R, Rombi, B, Timmermann, B, Van Beek, K, Vela, A, Vennarini, S, Vestergaard, A, Vidal, M, Vondracek, V, Weber, DC, Whitfield, G, Zimmerman, J, Maduro, JH & Lassen-Ramshad, Y 2024, 'Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy', Radiotherapy and Oncology, vol. 198, 110414. https://doi.org/10.1016/j.radonc.2024.110414

TY - JOUR

T1 - Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy

AU - Toussaint, Laura

AU - Matysiak, Witold

AU - Alapetite, Claire

AU - Aristu, Javier

AU - Bannink-Gawryszuk, Agata

AU - Bolle, Stephanie

AU - Bolsi, Alessandra

AU - Calvo, Felipe

AU - Cerron Campoo, Fernando

AU - Charlwood, Frances

AU - Demoor-Goldschmidt, Charlotte

AU - Doyen, Jérôme

AU - Drosik-Rutowicz, Katarzyna

AU - Dutheil, Pauline

AU - Embring, Anna

AU - Engellau, Jacob

AU - Goedgebeur, Anneleen

AU - Goudjil, Farid

AU - Harrabi, Semi

AU - Kopec, Renata

AU - Kristensen, Ingrid

AU - Lægsdmand, Peter

AU - Lütgendorf-Caucig, Carola

AU - Meijers, Arturs

AU - Mirandola, Alfredo

AU - Missohou, Fernand

AU - Montero Feijoo, Marta

AU - Muren, Ludvig P

AU - Ondrova, Barbora

AU - Orlandi, Ester

AU - Pettersson, Erik

AU - Pica, Alessia

AU - Plaude, Sandija

AU - Righetto, Roberto

AU - Rombi, Barbara

AU - Timmermann, Beate

AU - Van Beek, Karen

AU - Vela, Anthony

AU - Vennarini, Sabina

AU - Vestergaard, Anne

AU - Vidal, Marie

AU - Vondracek, Vladimir

AU - Weber, Damien C

AU - Whitfield, Gillian

AU - Zimmerman, Jens

AU - Maduro, John H

AU - Lassen-Ramshad, Yasmin

PY - 2024/9

Y1 - 2024/9

N2 - 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.

AB - 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.

KW - Humans

KW - Proton Therapy/methods

KW - Infratentorial Neoplasms/radiotherapy

KW - Europe

KW - Child

KW - Radiotherapy Planning, Computer-Assisted/methods

KW - Radiotherapy Dosage

KW - Child, Preschool

KW - Male

KW - Female

KW - Organs at Risk/radiation effects

KW - Brain Stem/radiation effects

U2 - 10.1016/j.radonc.2024.110414

DO - 10.1016/j.radonc.2024.110414

M3 - Article

C2 - 38942120

SN - 0167-8140

VL - 198

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

M1 - 110414

ER -

Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy

Abstract

Keywords

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