A systematic review of clinical studies on variable proton Relative Biological Effectiveness (RBE)
McNamara, A. L.
Haviland, J. S.
Singers Sørensen, B.
Troost, E. G. C.
AffiliationDivision of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
MetadataShow full item record
AbstractRecently, a number of clinical studies have explored links between possible Relative Biological Effectiveness (RBE) elevations and patient toxicities and/or image changes following proton therapy. Our objective was to perform a systematic review of such studies. We applied a "Problem [RBE], Intervention [Protons], Population [Patients], Outcome [Side effect]" search strategy to the PubMed database. From our search, we retrieved studies which: (a) performed novel voxel-wise analyses of patient effects versus physical dose and LET (n = 13), and (b) compared image changes between proton and photon cohorts with regard to proton RBE (n = 9). For each retrieved study, we extracted data regarding: primary tumour type; size of patient cohort; type of image change studied; image-registration method (deformable or rigid); LET calculation method, and statistical methodology. We compared and contrasted their methods in order to discuss the weight of clinical evidence for variable proton RBE. We concluded that clinical evidence for variable proton RBE remains statistically weak at present. Our principal recommendation is that proton centres and clinical trial teams collaborate to standardize follow-up protocols and statistical analysis methods, so that larger patient cohorts can ultimately be considered for RBE analyses.
CitationSa Underwood T, McNamara AL, Appelt A, Haviland JS, Singers Sørensen B, Troost EGC. A systematic review of clinical studies on variable proton Relative Biological Effectiveness (RBE). Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2022 Aug 18. PubMed PMID: 35988776. Epub 2022/08/22. eng.
JournalRadiotherapy and Oncology
- Clinical use and future requirements of relative biological effectiveness: Survey among all European proton therapy centres.
- Authors: Heuchel L, Hahn C, Pawelke J, Sørensen BS, Dosanjh M, Lühr A
- Issue date: 2022 Jul
- Variable RBE in proton therapy: comparison of different model predictions and their influence on clinical-like scenarios.
- Authors: Giovannini G, Böhlen T, Cabal G, Bauer J, Tessonnier T, Frey K, Debus J, Mairani A, Parodi K
- Issue date: 2016 May 17
- Inclusion of a variable RBE into proton and photon plan comparison for various fractionation schedules in prostate radiation therapy.
- Authors: Ödén J, Eriksson K, Toma-Dasu I
- Issue date: 2017 Mar
- LET-weighted doses effectively reduce biological variability in proton radiotherapy planning.
- Authors: McMahon SJ, Paganetti H, Prise KM
- Issue date: 2018 Nov 9
- Introducing Proton Track-End Objectives in Intensity Modulated Proton Therapy Optimization to Reduce Linear Energy Transfer and Relative Biological Effectiveness in Critical Structures.
- Authors: Traneus E, Ödén J
- Issue date: 2019 Mar 1