Secondary Malignancy Risk Following Proton vs. X-ray Radiotherapy of Thymic Epithelial Tumors: A Comparative Modeling Study of Thoracic Organ-Specific Cancer Risk.

intensity-modulated radiotherapy (IMRT) photon radiotherapy proton therapy radiation-induced cancers thymic carcinoma thymoma

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
13 May 2022
Historique:
received: 01 11 2021
revised: 22 04 2022
accepted: 11 05 2022
entrez: 28 5 2022
pubmed: 29 5 2022
medline: 29 5 2022
Statut: epublish

Résumé

Proton beam radiotherapy (PBT) offers physical dose advantages that might reduce the risk for secondary malignancies (SM). The aim of the current study is to calculate the risk for SM after X-ray-based 3D conformal (3DCRT) radiotherapy, intensity-modulated radiotherapy (IMRT), and active pencil beam scanned proton therapy (PBS) in patients treated for thymic malignancies. Comparative treatment plans for each of the different treatment modalities were generated for 17 patients. The risk for radiation-induced SM was estimated using two distinct prediction models-the Dasu and the Schneider model. The total and fatal SM risks estimated using the Dasu model demonstrated significant reductions with the use of PBS relative to both 3DCRT and IMRT for all independent thoracic organs analyzed with the exception of the thyroid gland ( PBS achieved superior sparing of relevant OARs compared to 3DCRT and IMRT, leading to a lower risk for radiation-induced SM. PBS should therefore be considered in patients diagnosed with thymic malignancies, particularly young female patients.

Sections du résumé

BACKGROUND BACKGROUND
Proton beam radiotherapy (PBT) offers physical dose advantages that might reduce the risk for secondary malignancies (SM). The aim of the current study is to calculate the risk for SM after X-ray-based 3D conformal (3DCRT) radiotherapy, intensity-modulated radiotherapy (IMRT), and active pencil beam scanned proton therapy (PBS) in patients treated for thymic malignancies.
METHODS METHODS
Comparative treatment plans for each of the different treatment modalities were generated for 17 patients. The risk for radiation-induced SM was estimated using two distinct prediction models-the Dasu and the Schneider model.
RESULTS RESULTS
The total and fatal SM risks estimated using the Dasu model demonstrated significant reductions with the use of PBS relative to both 3DCRT and IMRT for all independent thoracic organs analyzed with the exception of the thyroid gland (
CONCLUSIONS CONCLUSIONS
PBS achieved superior sparing of relevant OARs compared to 3DCRT and IMRT, leading to a lower risk for radiation-induced SM. PBS should therefore be considered in patients diagnosed with thymic malignancies, particularly young female patients.

Identifiants

pubmed: 35626013
pii: cancers14102409
doi: 10.3390/cancers14102409
pmc: PMC9139629
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Z Med Phys. 2005;15(1):31-7
pubmed: 15830782
Asian Cardiovasc Thorac Ann. 2018 May;26(4):290-295
pubmed: 29528688
Bull Cancer. 2013 Dec;100(12):1333-42
pubmed: 24257106
Transl Lung Cancer Res. 2018 Apr;7(2):106-113
pubmed: 29876309
Future Oncol. 2018 Aug;14(19):1943-1951
pubmed: 30081670
Cancer. 2001 Nov 1;92(9):2406-11
pubmed: 11745297
Int J Cancer. 2003 Dec 10;107(5):868-70
pubmed: 14566841
Ann Oncol. 2015 Sep;26 Suppl 5:v40-55
pubmed: 26314779
Acta Oncol. 1999;38(2):137-45
pubmed: 10227433
Int J Cancer. 2003 Jul 1;105(4):546-51
pubmed: 12712448
Acta Oncol. 2021 May;60(5):649-652
pubmed: 33629926
Acta Oncol. 2005;44(4):339-47
pubmed: 16120542
Radiother Oncol. 2016 Mar;118(3):504-9
pubmed: 26895711
Int J Cancer. 2011 Jun 1;128(11):2688-94
pubmed: 20669226
J Thorac Dis. 2018 Aug;10(Suppl 21):S2555-S2564
pubmed: 30206499
J Thorac Oncol. 2015 Oct;10(10):1383-95
pubmed: 26295375
Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1510-5
pubmed: 15817357
J Thorac Oncol. 2017 Apr;12(4):734-744
pubmed: 28126540
Phys Med. 2017 Oct;42:263-270
pubmed: 28366554
J Thorac Oncol. 2011 Jul;6(7 Suppl 3):S1743-8
pubmed: 21847057
Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):1-7
pubmed: 16618572
Acta Oncol. 2018 Dec;57(12):1713-1720
pubmed: 30264630
Clin Lung Cancer. 2016 Sep;17(5):362-366
pubmed: 27372386
Strahlenther Onkol. 2016 Nov;192(11):770-779
pubmed: 27334276
Int J Radiat Oncol Biol Phys. 2017 Oct 1;99(2):427-433
pubmed: 28871993

Auteurs

Laila König (L)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.

Juliane Hörner-Rieber (J)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.

Matthew Forsthoefel (M)

Department of Radiation Oncology, Radiotherapy Centers of Kentuckiana, Louisville, KY 47130, USA.
Department of Radiation Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC 20007, USA.

Peter Haering (P)

Department for Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.

Eva Meixner (E)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.

Tanja Eichkorn (T)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.

Anna Krämer (A)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.

Thomas Mielke (T)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.

Eric Tonndorf-Martini (E)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.

Matthias F Haefner (MF)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.

Jürgen Debus (J)

Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany.
Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
German Cancer Consortium (DKTK), Partner Site Heidelberg, 69120 Heidelberg, Germany.

Jonathan W Lischalk (JW)

Department of Radiation Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC 20007, USA.
Department of Radiation Oncology, Perlmutter Cancer Center, New York University Langone Hospital-Long Island, 150 Amsterdam Ave., New York, NY 10023, USA.

Classifications MeSH