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Cancer risk after b...
Cancer risk after breast proton therapy considering physiological and radiobiological uncertainties
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- Raptis, Apostolos (författare)
- The Skandion Clinic, Uppsala, Sweden.
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- Ödén, Jakob (författare)
- Stockholms universitet,Fysikum,Department of Physics, Medical Radiation Physics, Stockholm University, Stockholm, Sweden.; RaySearch Laboratories AB, Stockholm, Sweden.
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- Ardenfors, Oscar (författare)
- Karolinska Institutet,Stockholms universitet,Fysikum,Department of Physics, Medical Radiation Physics, Stockholm University, Stockholm, Sweden.
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- Flejmer, Anna M. (författare)
- The Skandion Clinic, Uppsala, Sweden.
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- Toma-Dasu, Iuliana (författare)
- Karolinska Institutet,Stockholms universitet,Fysikum,Department of Physics, Medical Radiation Physics, Stockholm University, Stockholm, Sweden.; Department of Oncology and Pathology, Medical Radiation Physics, Karolinska Institutet, Stockholm, Sweden.
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- Dasu, Alexandru (författare)
- Uppsala universitet,Institutionen för immunologi, genetik och patologi,The Skandion Clinic, Uppsala, Sweden.
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The Skandion Clinic, Uppsala, Sweden Fysikum (creator_code:org_t)
- Elsevier BV, 2020
- 2020
- Engelska.
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Ingår i: Physica medica (Testo stampato). - : Elsevier BV. - 1120-1797 .- 1724-191X. ; 76, s. 1-6
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Background: The reduced normal tissue dose burden from protons can reduce the risk of second cancer for breast cancer patients. Breathing motion and the impact of variable relative biological effectiveness (RBE) are however concerns for proton dose distributions. This study aimed to quantify the impact of these factors on risk predictions from proton and photon therapy.Materials and methods: Twelve patients were planned in free breathing with protons and photons to deliver 50 Gy (RBE) in 25 fractions (assuming RBE = 1.1 for protons) to the left breast. Second cancer risk was evaluated with several models for the lungs, contralateral breast, heart and esophagus as organs at risk (OARs). Plans were recalculated on CT-datasets acquired in extreme phases to account for breathing motion. Proton plans were also recalculated assuming variable RBE for a range of radiobiological parameters.Results: The OARs received substantially lower doses from protons compared to photons. The highest risks were for the lungs (average second cancer risks of 0.31% and 0.12% from photon and proton plans, respectively). The reduced risk with protons was maintained, even when breathing and/or RBE variation were taken into account. Furthermore, while the total risks from the photon plans were seen to increase with the integral dose, no such correlation was observed for the proton plans.Conclusions: Protons have an advantage over the photons with respect to the induction of cancer. Uncertainties in physiological movements and radiobiological parameters affected the absolute risk estimates, but not the general trend of lower risk associated with proton therapy.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- NATURVETENSKAP -- Fysik (hsv//swe)
- NATURAL SCIENCES -- Physical Sciences (hsv//eng)
Nyckelord
- Risk of second cancer
- Proton therapy
- Breast cancer
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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