Variations in linear energy transfer distributions within a European proton therapy planning comparison of paediatric posterior fossa tumours

Peter Lægdsmand; Witold Matysiak; Ludvig P. Muren; Yasmin Lassen-Ramshad; John H. Maduro; Anne Vestergaard; Roberto Righetto; Erik Pettersson; Ingrid Kristensen; Pauline Dutheil; Charlotte Demoor-Goldschmidt; Frances Charlwood; Gillian Whitfield; Marta M. Feijoo; Anthony Vela; Fernand Missohou; Sabina Vennarini; Alfredo Mirandola; Ester Orlandi; Barbara Rombi; Anneleen Goedgebeur; Karen Van Beek; Agata Bannink-Gawryszuk; Fernando C. Campoo; Jacob Engellau; Laura Toussaint

doi:10.1016/j.phro.2024.100675

Variations in linear energy transfer distributions within a European proton therapy planning comparison of paediatric posterior fossa tumours

Peter Lægdsmand, Witold Matysiak, Ludvig P. Muren, Yasmin Lassen-Ramshad, John H. Maduro, Anne Vestergaard, Roberto Righetto, Erik Pettersson, Ingrid Kristensen, Pauline Dutheil, Charlotte Demoor-Goldschmidt, Frances Charlwood, Gillian Whitfield, Marta M. Feijoo, Anthony Vela, Fernand Missohou, Sabina Vennarini, Alfredo Mirandola, Ester Orlandi, Barbara RombiAnneleen Goedgebeur, Karen Van Beek, Agata Bannink-Gawryszuk, Fernando C. Campoo, Jacob Engellau, Laura Toussaint^*

^*Corresponding author for this work

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

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Abstract

Background and Purpose: Radiotherapy for paediatric posterior fossa tumours may cause complications in the brainstem and upper spinal cord due to high doses. With proton therapy (PT) this risk may increase due to higher relative biological effectiveness (RBE) from elevated linear energy transfer (LET). This study assesses variations in LET in the brainstem and spinal cord in proton treatment plans from European centres.

Materials and Methods: Ten European PT centres using spot-scanning PT planned two paediatric posterior fossa cases: One overlapping partly with the brainstem and upper spinal cord, prescribed 54 Gy(RBE), and the second wrapping around these organs, prescribed 59.4 Gy(RBE). Dose-averaged LET distributions were assessed in volumes of the brainstem and spinal cord irradiated to over 50 Gy(RBE = 1.1). The maximum hinge angle effect on near-maximum RBE-weighted doses using the Unkelbach RBE model was also investigated.

Results: In the first case, the mean LET in brainstem volumes receiving more than 50 Gy(RBE = 1.1) ranged from 2.8 keV/µm to 3.6 keV/µm across centres (median: 3.3 keV/µm). In the second case, treatment plans showed a narrower range of mean LET in the brainstem, from 2.5 keV/µm to 2.8 keV/µm (median: 2.7 keV/µm). There was no statistically significant impact of the maximum hinge angle.

Conclusions: LET distributions vary across centres due to different techniques but are also influenced significantly by factors like shape and position of the target volume.

Original language	English
Article number	100675
Number of pages	8
Journal	Physics and imaging in radiation oncology
Volume	32
DOIs	https://doi.org/10.1016/j.phro.2024.100675
Publication status	Published - Oct-2024

Keywords

Brainstem
Linear Energy Transfer
Paediatric
Posterior fossa tumours
Proton therapy
Relative Biological Effectiveness
Spinal cord

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Lægdsmand, P., Matysiak, W., Muren, L. P., Lassen-Ramshad, Y., Maduro, J. H., Vestergaard, A., Righetto, R., Pettersson, E., Kristensen, I., Dutheil, P., Demoor-Goldschmidt, C., Charlwood, F., Whitfield, G., Feijoo, M. M., Vela, A., Missohou, F., Vennarini, S., Mirandola, A., Orlandi, E., ... Toussaint, L. (2024). Variations in linear energy transfer distributions within a European proton therapy planning comparison of paediatric posterior fossa tumours. Physics and imaging in radiation oncology, 32, Article 100675. https://doi.org/10.1016/j.phro.2024.100675

@article{cf531276bc8d4302826d5c43379c87af,

title = "Variations in linear energy transfer distributions within a European proton therapy planning comparison of paediatric posterior fossa tumours",

abstract = "Background and Purpose: Radiotherapy for paediatric posterior fossa tumours may cause complications in the brainstem and upper spinal cord due to high doses. With proton therapy (PT) this risk may increase due to higher relative biological effectiveness (RBE) from elevated linear energy transfer (LET). This study assesses variations in LET in the brainstem and spinal cord in proton treatment plans from European centres.Materials and Methods: Ten European PT centres using spot-scanning PT planned two paediatric posterior fossa cases: One overlapping partly with the brainstem and upper spinal cord, prescribed 54 Gy(RBE), and the second wrapping around these organs, prescribed 59.4 Gy(RBE). Dose-averaged LET distributions were assessed in volumes of the brainstem and spinal cord irradiated to over 50 Gy(RBE = 1.1). The maximum hinge angle effect on near-maximum RBE-weighted doses using the Unkelbach RBE model was also investigated.Results: In the first case, the mean LET in brainstem volumes receiving more than 50 Gy(RBE = 1.1) ranged from 2.8 keV/µm to 3.6 keV/µm across centres (median: 3.3 keV/µm). In the second case, treatment plans showed a narrower range of mean LET in the brainstem, from 2.5 keV/µm to 2.8 keV/µm (median: 2.7 keV/µm). There was no statistically significant impact of the maximum hinge angle.Conclusions: LET distributions vary across centres due to different techniques but are also influenced significantly by factors like shape and position of the target volume.",

keywords = "Brainstem, Linear Energy Transfer, Paediatric, Posterior fossa tumours, Proton therapy, Relative Biological Effectiveness, Spinal cord",

author = "Peter L{\ae}gdsmand and Witold Matysiak and Muren, {Ludvig P.} and Yasmin Lassen-Ramshad and Maduro, {John H.} and Anne Vestergaard and Roberto Righetto and Erik Pettersson and Ingrid Kristensen and Pauline Dutheil and Charlotte Demoor-Goldschmidt and Frances Charlwood and Gillian Whitfield and Feijoo, {Marta M.} and Anthony Vela and Fernand Missohou and Sabina Vennarini and Alfredo Mirandola and Ester Orlandi and Barbara Rombi and Anneleen Goedgebeur and {Van Beek}, Karen and Agata Bannink-Gawryszuk and Campoo, {Fernando C.} and Jacob Engellau and Laura Toussaint",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s)",

year = "2024",

month = oct,

doi = "10.1016/j.phro.2024.100675",

language = "English",

volume = "32",

journal = "Physics and imaging in radiation oncology",

issn = "2405-6316",

publisher = "Elsevier",

}

Lægdsmand, P, Matysiak, W, Muren, LP, Lassen-Ramshad, Y, Maduro, JH, Vestergaard, A, Righetto, R, Pettersson, E, Kristensen, I, Dutheil, P, Demoor-Goldschmidt, C, Charlwood, F, Whitfield, G, Feijoo, MM, Vela, A, Missohou, F, Vennarini, S, Mirandola, A, Orlandi, E, Rombi, B, Goedgebeur, A, Van Beek, K, Bannink-Gawryszuk, A, Campoo, FC, Engellau, J & Toussaint, L 2024, 'Variations in linear energy transfer distributions within a European proton therapy planning comparison of paediatric posterior fossa tumours', Physics and imaging in radiation oncology, vol. 32, 100675. https://doi.org/10.1016/j.phro.2024.100675

TY - JOUR

T1 - Variations in linear energy transfer distributions within a European proton therapy planning comparison of paediatric posterior fossa tumours

AU - Lægdsmand, Peter

AU - Matysiak, Witold

AU - Muren, Ludvig P.

AU - Lassen-Ramshad, Yasmin

AU - Maduro, John H.

AU - Vestergaard, Anne

AU - Righetto, Roberto

AU - Pettersson, Erik

AU - Kristensen, Ingrid

AU - Dutheil, Pauline

AU - Demoor-Goldschmidt, Charlotte

AU - Charlwood, Frances

AU - Whitfield, Gillian

AU - Feijoo, Marta M.

AU - Vela, Anthony

AU - Missohou, Fernand

AU - Vennarini, Sabina

AU - Mirandola, Alfredo

AU - Orlandi, Ester

AU - Rombi, Barbara

AU - Goedgebeur, Anneleen

AU - Van Beek, Karen

AU - Bannink-Gawryszuk, Agata

AU - Campoo, Fernando C.

AU - Engellau, Jacob

AU - Toussaint, Laura

PY - 2024/10

Y1 - 2024/10

N2 - Background and Purpose: Radiotherapy for paediatric posterior fossa tumours may cause complications in the brainstem and upper spinal cord due to high doses. With proton therapy (PT) this risk may increase due to higher relative biological effectiveness (RBE) from elevated linear energy transfer (LET). This study assesses variations in LET in the brainstem and spinal cord in proton treatment plans from European centres.Materials and Methods: Ten European PT centres using spot-scanning PT planned two paediatric posterior fossa cases: One overlapping partly with the brainstem and upper spinal cord, prescribed 54 Gy(RBE), and the second wrapping around these organs, prescribed 59.4 Gy(RBE). Dose-averaged LET distributions were assessed in volumes of the brainstem and spinal cord irradiated to over 50 Gy(RBE = 1.1). The maximum hinge angle effect on near-maximum RBE-weighted doses using the Unkelbach RBE model was also investigated.Results: In the first case, the mean LET in brainstem volumes receiving more than 50 Gy(RBE = 1.1) ranged from 2.8 keV/µm to 3.6 keV/µm across centres (median: 3.3 keV/µm). In the second case, treatment plans showed a narrower range of mean LET in the brainstem, from 2.5 keV/µm to 2.8 keV/µm (median: 2.7 keV/µm). There was no statistically significant impact of the maximum hinge angle.Conclusions: LET distributions vary across centres due to different techniques but are also influenced significantly by factors like shape and position of the target volume.

AB - Background and Purpose: Radiotherapy for paediatric posterior fossa tumours may cause complications in the brainstem and upper spinal cord due to high doses. With proton therapy (PT) this risk may increase due to higher relative biological effectiveness (RBE) from elevated linear energy transfer (LET). This study assesses variations in LET in the brainstem and spinal cord in proton treatment plans from European centres.Materials and Methods: Ten European PT centres using spot-scanning PT planned two paediatric posterior fossa cases: One overlapping partly with the brainstem and upper spinal cord, prescribed 54 Gy(RBE), and the second wrapping around these organs, prescribed 59.4 Gy(RBE). Dose-averaged LET distributions were assessed in volumes of the brainstem and spinal cord irradiated to over 50 Gy(RBE = 1.1). The maximum hinge angle effect on near-maximum RBE-weighted doses using the Unkelbach RBE model was also investigated.Results: In the first case, the mean LET in brainstem volumes receiving more than 50 Gy(RBE = 1.1) ranged from 2.8 keV/µm to 3.6 keV/µm across centres (median: 3.3 keV/µm). In the second case, treatment plans showed a narrower range of mean LET in the brainstem, from 2.5 keV/µm to 2.8 keV/µm (median: 2.7 keV/µm). There was no statistically significant impact of the maximum hinge angle.Conclusions: LET distributions vary across centres due to different techniques but are also influenced significantly by factors like shape and position of the target volume.

KW - Brainstem

KW - Linear Energy Transfer

KW - Paediatric

KW - Posterior fossa tumours

KW - Proton therapy

KW - Relative Biological Effectiveness

KW - Spinal cord

UR - http://www.scopus.com/inward/record.url?scp=85209588343&partnerID=8YFLogxK

U2 - 10.1016/j.phro.2024.100675

DO - 10.1016/j.phro.2024.100675

M3 - Article

C2 - 39803348

AN - SCOPUS:85209588343

SN - 2405-6316

VL - 32

JO - Physics and imaging in radiation oncology

JF - Physics and imaging in radiation oncology

M1 - 100675

ER -

Variations in linear energy transfer distributions within a European proton therapy planning comparison of paediatric posterior fossa tumours

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