PH-0328 Current practice for selection of adult patients for proton therapy across Europe

Tambaş, Makbule; Laan, Hans Paul van der; Steenbakkers, Roel J.H.M.; Doyen, J.; Timmermann, Beate; Orlandi, Ester; Høyer, M.; Haustermans, Karin; Georg, Petra; Burnet, N.G.; Kirkby, K.J.; Grégoire, Vincent; Calugaru, Valentin; Troost, E.G.C.; Hoebers, Frank; Widder, Joachim; Eberle, F.; Vulpen, Marco van; Maingon, P.; Skóra, Tomasz; Weber, D.C.; Bergfeldt, Kjell; Kubeš, Jiří; Langendijk, Johannes A.

doi:10.1016/s0167-8140(21)07301-1

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“…Based on the 2019 data of the National Association for Proton Therapy survey, HNC patients constituted 14.2% of all patients treated in 28 PT centers in USA, compared to 5.8% in 2012 and showed the strongest increase in the number of patients treated with PT compared with other tumor sites [4]. A similar trend was also observed in European PT centers, with HNC being the most commonly treated indication following CNS tumors and comprising 15% of all adult patients treated with PT last year [5].…”

Section: Introductionmentioning

confidence: 82%

A Decision Support Tool to Optimize Selection of Head and Neck Cancer Patients for Proton Therapy

Tambaş

Laan

Schaaf

et al. 2022

Cancers

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Selection of head and neck cancer (HNC) patients for proton therapy (PT) using plan comparison (VMAT vs. IMPT) for each patient is labor-intensive. Our aim was to develop a decision support tool to identify patients with high probability to qualify for PT, at a very early stage (immediately after delineation) to avoid delay in treatment initiation. A total of 151 HNC patients were included, of which 106 (70%) patients qualified for PT. Linear regression models for individual OARs were created to predict the Dmean to the OARs for VMAT and IMPT plans. The predictors were OAR volume percentages overlapping with target volumes. Then, actual and predicted plan comparison decisions were compared. Actual and predicted OAR Dmean (VMAT R2 = 0.953, IMPT R2 = 0.975) and NTCP values (VMAT R2 = 0.986, IMPT R2 = 0.992) were highly correlated. The sensitivity, specificity, PPV and NPV of the decision support tool were 64%, 87%, 92% and 51%, respectively. The expected toxicity reduction with IMPT can be predicted using only the delineation data. The probability of qualifying for PT is >90% when the tool indicates a positive outcome for PT. This tool will contribute significantly to a more effective selection of HNC patients for PT at a much earlier stage, reducing treatment delay.

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Section: Introductionmentioning

confidence: 82%