Evidence map›Paper›PMID 38886727›Full record

ArticleRadiation oncology (London, England)2024

Possible association of dose rate and the development of late visual toxicity for patients with intracranial tumours treated with pencil beam scanned proton therapy.

Arturs Meijers, Juliane Daartz, Antje-Christin Knopf, Michelle van Heerden, Nicola Bizzocchi, Miriam Varela Vazquez, Barbara Bachtiary, Alessia Pica, Helen A Shih, Damien Charles Weber

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Article in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Arturs MeijersCenter for Proton Therapy, Paul Scherrer Institut, Forschungsstrasse 111, Villigen, 5232, Switzerland. arturs.meijers@psi.ch.
Juliane DaartzDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Antje-Christin KnopfInstitute for Medical Engineering and Medical Informatics, School of Life Science FHNW, Muttenz, Switzerland.
Michelle van HeerdenCenter for Proton Therapy, Paul Scherrer Institut, Forschungsstrasse 111, Villigen, 5232, Switzerland.
Nicola BizzocchiCenter for Proton Therapy, Paul Scherrer Institut, Forschungsstrasse 111, Villigen, 5232, Switzerland.
Miriam Varela VazquezCenter for Proton Therapy, Paul Scherrer Institut, Forschungsstrasse 111, Villigen, 5232, Switzerland.
Barbara BachtiaryCenter for Proton Therapy, Paul Scherrer Institut, Forschungsstrasse 111, Villigen, 5232, Switzerland.
Alessia PicaCenter for Proton Therapy, Paul Scherrer Institut, Forschungsstrasse 111, Villigen, 5232, Switzerland.
Helen A ShihDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
Damien Charles WeberCenter for Proton Therapy, Paul Scherrer Institut, Forschungsstrasse 111, Villigen, 5232, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeRare but severe toxicities of the optic apparatus have been observed after treatment of intracranial tumours with proton therapy. Some adverse events have occurred at unusually low dose levels and are thus difficult to understand considering dose metrics only. When transitioning from double scattering to pencil beam scanning, little consideration was given to increased dose rates observed with the latter delivery paradigm. We explored if dose rate related metrics could provide additional predicting factors for the development of late visual toxicities. MATERIALS AND

methodsRadiation-induced intracranial visual pathway lesions were delineated on MRI for all index cases. Voxel-wise maximum dose rate (MDR) was calculated for 2 patients with observed optic nerve toxicities (CTCAE grade 3 and 4), and 6 similar control cases. Additionally, linear energy transfer (LET) related dose enhancing metrics were investigated.

resultsFor the index cases, which developed toxicities at low dose levels (mean, 50 Gy

conclusionsOur observations reveal large variations in instantaneous dose rates experienced by different volumes within our patient cohort, even when considering the same indications and beam arrangement. High dose rate regions are spatially overlapping with the radiation induced toxicity areas in the follow up images. At this point, it is not feasible to establish causality between exposure to high dose rates and the development of late optic apparatus toxicities due to the low incidence of injury.

Indexed as

Brain NeoplasmsProton TherapyRadiation InjuriesRadiotherapy DosageAdultAgedDose-Response Relationship, RadiationFemaleHumansMaleMiddle AgedOptic NerveOrgans at RiskRadiotherapy Planning, Computer-AssistedDose rateProton therapyRadiation induced neuropathyVisual toxicity

Identifiers

PMID38886727
PMCPMC11184872

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.