• Login
    View Item 
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of ChristieCommunitiesTitleAuthorsIssue DateSubmit DateSubjectsThis CollectionTitleAuthorsIssue DateSubmit DateSubjects

    My Account

    LoginRegister

    Local Links

    The Christie WebsiteChristie Library and Knowledge Service

    Statistics

    Display statistics

    Protons in posterior fossa ependymoma- a dosimetric comparison with photons

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Authors
    Kannikanti, D. H.
    Charlwood, Frances C
    Clarke, Matthew F
    Colaco, Rovel J
    Pan, Shermaine
    Saunders, Daniel
    Sitch, Peter
    Thorp, N.
    Whitfield, Gillian A
    Rasool, M.
    Affiliation
    The Christie NHS Foundation Trust, Proton Beam Therapy Centre, Manchester
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Purpose or Objective Adjuvant radiotherapy in ependymoma improves both local control and survival outcomes. The 5 year overall survival in paediatric ependymoma is around 85%. With such outcomes, the late effects of treatment assume prime importance. Protons when compared with photons have the potential to spare organs at risk (OARs), and thereby decrease late complications. This study was designed to compare the dosimetry of proton with photon radiotherapy plans in patients with posterior fossa ependymoma, in order to understand the potential for reduced late effects. Materials and Methods Data were extracted for ten patients with posterior fossa ependymoma treated with protons who had Volumetric Modulated Arc Therapy (VMAT) photon plans prepared in case of cyclotron downtime. Five were single phase plans to a total dose of 59.4Gy in 33 fractions, with appropriate limitation of dose at spinal cord level, and 5 were two phase plans, to 54Gy in 30 fractions followed by a boost of 5.4Gy in 3 fractions to the volume above the foramen magnum. Clinically relevant dosimetric variables of target and routinely outlined OARs for data collection were selected based on our clinical practice and with reference to the European Particle Therapy Network (EPTN) consensus on radiation dose constraints for OARs in neuro-oncology. Mean values were compared between proton and photon plans using a two tailed paired sample t-test. P values of less than 0.05 were considered statistically significant. Results Of ten patients, 7 were females. The median age was 7 years (range 3 to 17 years). For almost all dosimetric variables, proton plans showed a statistically significant dosimetric advantage in OAR variables, including to the optic nerves and chiasm, cochleae, pituitary gland, hypothalamus, hippocampi, temporal lobes, brain and brainstem. The mean D0.03cc for brainstem, skin and spinal cord were not statistically significantly different between modalities (Figure 1). The mean integral dose was significantly lower in protons compared to photons (p=0.00) with a median proton to photon integral dose ratio of 0.55 (range-0.41 to 0.74). The mean percentage of the PTV receiving 95% of prescription dose and the mean homogeneity index were not statistically significantly different between proton and photon plans (p=0.11 and p=0.98 respectively. Conclusion This study showed marked dosimetric advantage for protons in OAR sparing and lowered integral doses, while maintaining similar target volume coverage. This is anticipated to reduce the risk of late effects, particularly hearing loss, endocrine dysfunction, neurocognitive effects, and second malignancies, while maintaining the established high rates of local control with photons.
    Citation
    Kannikanti DH, Charlwood F, Clarke M, Colaco R, Pan S, Saunders D, et al. Protons in posterior fossa ependymoma- a dosimetric comparison with photons. Radiotherapy and Oncology. 2022 May;170:S984-S5. PubMed PMID: WOS:000806764200636.
    Journal
    Radiotherapy and Oncology
    URI
    http://hdl.handle.net/10541/625483
    Type
    Meetings and Proceedings
    Language
    en
    Collections
    All Christie Publications

    entitlement

     
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.