ArticleJournal of cancer research and clinical oncology2020
Volumetric modulated arc therapy versus intensity-modulated proton therapy in the postoperative irradiation of thymoma.
Article in Journal of cancer research and clinical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Optimising individualised treatment decisions for locally advanced thymoma: precision selection of minimally invasive surgery and postoperative adjuvant radiotherapy.Frontiers in oncology · 2026Review
- Dose and normal tissue complication probability analysis of various radiotherapy regimens for thymomas.Frontiers in oncology · 2026Article
- Postoperative radiotherapy for thymic epithelial tumors: a narrative review.Mediastinum (Hong Kong, China) · 2024Review
- NTCP Calculations of Five Different Irradiation Techniques for the Treatment of Thymoma.Current oncology (Toronto, Ont.) · 2023Article
- Chinese expert consensus on the diagnosis and treatment of thymic epithelial tumors.Thoracic cancer · 2023Article
- "Radiotherapy for thymic epithelial tumors: What is the optimal dose? A systematic review."Clinical and translational radiation oncology · 2022Review
- Estimated Risk of Radiation-Induced Cancer after Thymoma Treatments with Proton- or X-ray Beams.Cancers · 2021Article
- GOECP/SEOR radiotherapy guidelines for thymic epithelial tumours.World journal of clinical oncology · 2021Review
- Hadrontherapy for Thymic Epithelial Tumors: Implementation in Clinical Practice.Frontiers in oncology · 2021Review
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo investigate the role of intensity-modulated proton therapy (IMPT) compared to volumetric modulated arc therapy (VMAT) for the radiation treatment of thymoma cancer.
methodsTwenty patients were retrospectively planned for IMPT [with (IMPT_R1 or IMPT_R2 according to the approach adopted) and without robust optimization] and VMAT. The results were compared according to dose-volume metrics on the clinical and planning target volumes (CTV and PTV) and the main organs at risk (heart, breasts, lungs, spinal cord and oesophagus). Estimates of the excess absolute risk (EAR) of secondary cancer induction were determined for the oesophagus, the breasts and the composite lungs. For the heart, the relative risk (RR) of chronic heart failure (CHF) was assessed.
resultsIMPT and VMAT plans resulted equivalent in terms of target coverage for both the CTV and the PTV. The CTV homogeneity index resulted in 0.03 ± 0.01 and 0.04 ± 0.01 for VMAT and all IMPT plans, respectively. The conformality index resulted in 1.1 ± 0.1 and 1.2 ± 0.1 for VMAT and all IMPT plans. The mean dose to the breasts resulted in 10.5 ± 5.0, 4.5 ± 3.4, 4.7 ± 3.5 and 4.6 ± 3.4 Gy for VMAT, IMPT, IMPT_R1 and IMPT_R2. For the lungs, the mean dose was 9.6 ± 2.3, 3.5 ± 1.5, 3.6 ± 1.6 and 3.8 ± 1.4 Gy; for the heart: 8.7 ± 4.4, 4.3 ± 1.9, 4.5 ± 2.0 and 4.4 ± 2.4 Gy and for the oesophagus 8.2 ± 3.5, 2.2 ± 3.4, 2.4 ± 3.6 and 2.5 ± 3.5 Gy. The RR for CHF was 1.6 ± 0.3 for VMAT and 1.3 ± 0.2 for IMPT (R1 or R2). The EAR was 3.6 ± 0.v vs 1.0 ± 0.6 or 1.2 ± 0.6 (excess cases/10,000 patients year) for the oesophagus; 17.4 ± 6.5 vs 5.7 ± 3.2 or 6.1 ± 3.8 for the breasts and 24.8 ± 4.3 vs 8.1 ± 2.7 or 8.7 ± 2.3 for the composite lungs for VMAT and IMPT_R, respectively.
conclusionThe data from this in-silico study suggest that intensity-modulated proton therapy could be significantly advantageous in the treatment of thymoma patients with particular emphasis to a substantial reduction of the risk of cardiac failure and secondary cancer induction. Robust planning is a technical pre-requisite for the safety of the delivery.
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