Treatment planning comparison in the PROTECT-trial randomising proton versus photon beam therapy in oesophageal cancer: Results from eight European centres

Proton versus photon therapy for esophageal cancer – A trimodality strategy (PROTECT) NCT050555648

“…Radiotherapy guidelines are described in detail in the PROTECT RTQA guideline including target definition and delineation, radiation dose constraints to normal tissue, tolerances for daily image guidance, as well as treatment planning, robustness evaluation, and weekly 4DCTbased verification and adaptation. Completed and accepted pre-trial target delineation [13] and planning of benchmark cases [14],…”

Clinical introduction of MR-guided radiotherapy for esophageal cancer

“…Tissue sparing might also be achieved when using proton beam therapy instead of photon therapy, as the Bragg peak in proton therapy results in lower entry and exit doses. 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].…”