Bone versus soft-tissue setup in proton therapy for patients with oesophageal cancer

Shamshad, Muhammad; Møller, D.S.; Mortensen, Hanna Rahbek; Ehmsen, Mai Lykkegaard; Hoffmann, Lone

doi:10.1080/0284186x.2022.2091949

Cited by 4 publications

(1 citation statement)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Planning studies have shown that treatment with proton beam therapy has the potential to significantly reduce dose to organs-at-risk in comparison to conventional photon therapy treatment for esophageal cancer [122][123][124]. However, proton beam therapy is associated with a range of uncertainties and whereas photons beams are relatively insensitive to density changes, these uncertainties become more complex and prominent in proton therapy, often resulting in the need for replanning [125][126][127]. Nevertheless, it is important for both proton therapy and MRgRT with reduced treatment margins to manage motion, especially during dose delivery, to provide sufficient target coverage and to prevent radiation toxicity to surrounding tissue.…”

Section: The Dosimetric Benefit Of Mrgrtmentioning

confidence: 99%

Clinical introduction of MR-guided radiotherapy for esophageal cancer

Boekhoff

View full text Add to dashboard Cite

Radiotherapy for esophageal cancer requires the use of imaging to localize and visualize the tumor. This thesis describes the use of magnetic resonance imaging in the radiotherapy treatment of patients with esophageal cancer. The first part of this thesis showed that esophageal cancer tumors are subject to position and shape changes throughout the treatment period. We have calculated that a treatment margin of 8-10mm would have been sufficient to provide sufficient target coverage for most patients. However, some patients showed extreme interfraction motion, which indicates the need for adaptive treatment strategies. The second part of this thesis reported on our experiences with an online adaptive, MR-guided radiotherapy treatment workflow. This adaptive strategy used day-to-day plan adaptation with smaller treatment margins of 6 mm. We have shown that this workflow is moderately feasible, mainly caused by the long treatment time of up to one hour per treatment session. We concluded that optimization of the presented clinical workflow is required. Nevertheless, the adaptive treatment strategy resulted in a dose reduction to the organs-at-risk compared to conventional treatment. This might allow for employment of improved treatment strategies, such as boosting strategies, to use this dose reduction to potentially improve the result of radiotherapy treatments of esophageal cancer tumors.

show abstract