ArticleRadiation oncology (London, England)2019
Comparative photon and proton dosimetry for patients with mediastinal lymphoma in the era of Monte Carlo treatment planning and variable relative biological effectiveness.
Article in Radiation oncology (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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11 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Tracing scientific progress: thematic shifts and emerging directions in proton therapy for glioma based on top-cited papers.Frontiers in neurologyPooled it
- Clinical implementation of intensity modulated proton therapy in breath-hold for mediastinal lymphoma patients using surface monitoring and nasal high-flow therapy.Physics and imaging in radiation oncology · 2026Article
- Improved organs-of-interest dose reduction potential with intensity modulated proton therapy and breath-hold in mediastinal lymphoma.Physics and imaging in radiation oncology · 2026Article
- Radiation-Induced Valvular Heart Disease: A Narrative Review of Epidemiology, Diagnosis and Management.Journal of cardiovascular development and disease · 2025Review
- Application of the Deep Inspiration Breath-Hold Technique in Proton Therapy for Mediastinal Lymphomas: Initial Experience.Cancers · 2025Article
- Article
- Proton linear energy transfer and variable relative biological effectiveness for adolescent patients with Hodgkin lymphoma.BJR open · 2023Article
- Article
- Treatment of ocular tumors through a novel applicator on a conventional proton pencil beam scanning beamline.Scientific reports · 2022Article
- Quantification of biological range uncertainties in patients treated at the Krakow proton therapy centre.Radiation oncology (London, England) · 2022Article
- Proton Radiation Therapy After Chemotherapy in the Management of Aggressive Mediastinal Non-Hodgkin Lymphomas: A Particle Therapy Cooperative Group Lymphoma Subcommittee Collaboration.Advances in radiation oncologyArticle
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Authors and funding
8 authors at 4 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundExisting pencil beam analytical (PBA) algorithms for proton therapy treatment planning are not ideal for sites with heterogeneous tissue density and do not account for the spatial variations in proton relative biological effectiveness (vRBE). Using a commercially available Monte Carlo (MC) treatment planning system, we compared various dosimetric endpoints between proton PBA, proton MC, and photon treatment plans among patients with mediastinal lymphoma.
methodsEight mediastinal lymphoma patients with both free breathing (FB) and deep inspiration breath hold (DIBH) CT simulation scans were analyzed. The original PBA plans were re-calculated with MC. New proton plans that used MC for both optimization and dose calculation with equivalent CTV/ITV coverage were also created. A vRBE model, which uses a published model for DNA double strand break (DSB) induction, was applied on MC plans to study the potential impact of vRBE on cardiac doses. Comparative photon plans were generated on the DIBH scan.
resultsRe-calculation of FB PBA plans with MC demonstrated significant under coverage of the ITV V99 and V95. Target coverage was recovered by re-optimizing the PT plan with MC with minimal change to OAR doses. Compared to photons with DIBH, MC-optimized FB and DIBH proton plans had significantly lower dose to the mean lung, lung V5, breast tissue, and spinal cord for similar target coverage. Even with application of vRBE in the proton plans, the putative increase in RBE at the end of range did not decrease the dosimetric advantages of proton therapy in cardiac substructures.
conclusionsMC should be used for PT treatment planning of mediastinal lymphoma to ensure adequate coverage of target volumes. Our preliminary data suggests that MC-optimized PT plans have better sparing of the lung and breast tissue compared to photons. Also, the potential for end of range RBE effects are unlikely to be large enough to offset the dosimetric advantages of proton therapy in cardiac substructures for mediastinal targets, although these dosimetric findings require validation with late toxicity data.
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