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
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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
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