Potential benefits of intensity-modulated proton therapy in head and neck cancer

Tara Arpana van de Water

Potential benefits of intensity-modulated proton therapy in head and neck cancer

Tara Arpana van de Water

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In patiënten met hoofd-halskanker zijn de doelvolumes vaak groot en complex van vorm en omringd door veel risico-organen en vitale structuren. Radiotherapie van het hoofd-halsgebied leidt daarom vaak tot verschillende ongewenste acute en late neveneffecten die een negatieve invloed hebben op de kwaliteit van leven. Xerostomie (het hebben van een droge mond) en slikproblemen zijn de twee belangrijkste radiatie-geïnduceerde late neveneffecten die de kwaliteit van leven van patiënten significant beïnvloeden.
De introductie van geavanceerde fotonen-radiotherapietechnieken heeft het mogelijk gemaakt om het hoge dosisgebied beter te conformeren aan het doelgebied en de normale weefsels beter te sparen. Verschillende studies hebben aangetoond dat in vergelijking met conventionele radiotherapie, de geavanceerdere intensiteitsgemoduleerde radiotherapie (IMRT) met fotonen, de risico-organen relevant voor xerostomie en slikproblemen beter kan sparen. Echter, IMRT resulteert niet altijd in een substantiële verbetering met betrekking tot het sparen van deze risico-organen. Geavanceerdere bestralingstechnieken, zoals protonentherapie (protonenbundeleigenschappen zijn superieur aan die van fotonen), kunnen daarom helpen om de dosisreductie in de relevante risico-organen verder te verbeteren en daarmee de kans op xerostomie en slikproblemen te verminderen.

Met de individuele in silico planningsvergelijkende studies, beschreven in dit proefschrift, zijn de potentiële voordelen van verschillende intensiteits-gemoduleerde protonentherapie (IMPT)-behandelplannen voor hoofd-halskanker met betrekking tot het reduceren van de kans op xerostomie en slikproblemen onderzocht, ten opzichte van IMRT-behandelplannen. De resultaten tonen aan dat IMPT relevante risico-organen substantieel kan sparen en daarom een bijdrage kan leveren aan een verbeterde kwaliteit van leven tijdens en na curatieve radiotherapie.

Originele taal-2	English
Begeleider(s)/adviseur	Langendijk, Johannes Albertus, Supervisor Lomax, A.J., Supervisor, Externe Persoon Schilstra, C, Supervisor Bijl, Henk, Supervisor
Datum van toekenning	13-mrt.-2013
Uitgever	[S.n.]
Gedrukte ISBN's	9789036760294
Elektronische ISBN's	9789036760287
Status	Published - 2013

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Title and contentsFinal author's version, 149 KB
Chapter 1Final author's version, 3,5 MB
Chapter 2Final author's version, 7,35 MB
Chapter 3Final author's version, 238 KB
Chapter 4Final author's version, 1,71 MB
Chapter 5Final author's version, 1,78 MB
Chapter 6Final author's version, 2,75 MB
Chapter 7Final author's version, 3,57 MB
General discussion and conclusionsFinal author's version, 611 KB
SummaryFinal author's version, 121 KB
ReferencesFinal author's version, 125 KB
AcknowledgementsFinal author's version, 63,7 KB
Curriculum vitaeFinal author's version, 108 KB
Complete dissertationFinal author's version, 21,1 MB

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@phdthesis{b7bfe7c9ed0d450d8c19774664c99fd1,

title = "Potential benefits of intensity-modulated proton therapy in head and neck cancer",

abstract = "Head and neck cancer target volumes are often complex shaped, large and surrounded by many critical and vital structures. Hence, radiotherapy of the head and neck region is frequently associated with a variety of radiation-induced acute and late side effects that adversely affect quality of life. The two most important radiation-induced late side effects significantly affecting patients{\textquoteright} quality of life are xerostomia (the sense of a dry mouth) and swallowing dysfunction.Introduction of advanced photon-based radiotherapy techniques have enabled better dose conformation to the target volume while reducing the normal tissue dose. Multiple studies have shown that compared with conventional radiotherapy, photon-based intensity-modulated radiotherapy (IMRT) can improve avoidance of the organs at risk (OARs) relevant for xerostomia and swallowing dysfunction. IMRT, however, does not always result in substantial improvements regarding sparing of those OARs. Hence, further dose reductions in all relevant OARs by using more advanced radiotherapy techniques, like proton therapy (protons have superior beam properties over photons), can help to reduce the probability of xerostomia and swallowing dysfunction.With the individual in silico planning comparison studies described in this thesis the potential benefits of different intensity-modulated proton therapy (IMPT) techniques in head and neck cancer have been explored, in relation to the current standard (IMRT), regarding reduction of xerostomia and swallowing dysfunction. The presented results indicate that IMPT may substantially improve sparing of the relevant OARs and hence may contribute to an improved quality of life during and after curatively intended radiotherapy.",

author = "{van de Water}, {Tara Arpana}",

year = "2013",

language = "English",

isbn = "9789036760294",

publisher = "[S.n.]",

}

TY - BOOK

T1 - Potential benefits of intensity-modulated proton therapy in head and neck cancer

AU - van de Water, Tara Arpana

PY - 2013

Y1 - 2013

N2 - Head and neck cancer target volumes are often complex shaped, large and surrounded by many critical and vital structures. Hence, radiotherapy of the head and neck region is frequently associated with a variety of radiation-induced acute and late side effects that adversely affect quality of life. The two most important radiation-induced late side effects significantly affecting patients’ quality of life are xerostomia (the sense of a dry mouth) and swallowing dysfunction.Introduction of advanced photon-based radiotherapy techniques have enabled better dose conformation to the target volume while reducing the normal tissue dose. Multiple studies have shown that compared with conventional radiotherapy, photon-based intensity-modulated radiotherapy (IMRT) can improve avoidance of the organs at risk (OARs) relevant for xerostomia and swallowing dysfunction. IMRT, however, does not always result in substantial improvements regarding sparing of those OARs. Hence, further dose reductions in all relevant OARs by using more advanced radiotherapy techniques, like proton therapy (protons have superior beam properties over photons), can help to reduce the probability of xerostomia and swallowing dysfunction.With the individual in silico planning comparison studies described in this thesis the potential benefits of different intensity-modulated proton therapy (IMPT) techniques in head and neck cancer have been explored, in relation to the current standard (IMRT), regarding reduction of xerostomia and swallowing dysfunction. The presented results indicate that IMPT may substantially improve sparing of the relevant OARs and hence may contribute to an improved quality of life during and after curatively intended radiotherapy.

AB - Head and neck cancer target volumes are often complex shaped, large and surrounded by many critical and vital structures. Hence, radiotherapy of the head and neck region is frequently associated with a variety of radiation-induced acute and late side effects that adversely affect quality of life. The two most important radiation-induced late side effects significantly affecting patients’ quality of life are xerostomia (the sense of a dry mouth) and swallowing dysfunction.Introduction of advanced photon-based radiotherapy techniques have enabled better dose conformation to the target volume while reducing the normal tissue dose. Multiple studies have shown that compared with conventional radiotherapy, photon-based intensity-modulated radiotherapy (IMRT) can improve avoidance of the organs at risk (OARs) relevant for xerostomia and swallowing dysfunction. IMRT, however, does not always result in substantial improvements regarding sparing of those OARs. Hence, further dose reductions in all relevant OARs by using more advanced radiotherapy techniques, like proton therapy (protons have superior beam properties over photons), can help to reduce the probability of xerostomia and swallowing dysfunction.With the individual in silico planning comparison studies described in this thesis the potential benefits of different intensity-modulated proton therapy (IMPT) techniques in head and neck cancer have been explored, in relation to the current standard (IMRT), regarding reduction of xerostomia and swallowing dysfunction. The presented results indicate that IMPT may substantially improve sparing of the relevant OARs and hence may contribute to an improved quality of life during and after curatively intended radiotherapy.

M3 - Thesis fully internal (DIV)

SN - 9789036760294

PB - [S.n.]

ER -

Potential benefits of intensity-modulated proton therapy in head and neck cancer

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