1
|
Trnková P, Dasu A, Placidi L, Stock M, Toma-Dasu I, Brouwer CL, Gosling A, Jouglar E, Kristensen I, Martin V, Moinuddin S, Pasquie I, Peters S, Pica A, Plaude S, Righetto R, Rombi B, Thariat J, van der Weide H, Hoffmann A, Bolsi A. Patterns of practice of image guided particle therapy for cranio-spinal irradiation: A site specific multi-institutional survey of European Particle Therapy Network. Phys Med 2024; 123:103407. [PMID: 38906046 DOI: 10.1016/j.ejmp.2024.103407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/22/2024] [Accepted: 06/07/2024] [Indexed: 06/23/2024] Open
Abstract
PURPOSE To investigate the current practice patterns in image-guided particle therapy (IGPT) for cranio-spinal irradiation (CSI). METHODS A multi-institutional survey was distributed to European particle therapy centres to analyse all aspects of IGPT. Based on the survey results, a Delphi consensus analysis was developed to define minimum requirements and optimal workflow for clinical practice. The centres participating in the institutional survey were invited to join the Delphi process. RESULTS Eleven centres participated in the survey. Imaging for treatment planning was rather similar among the centres with Computed Tomography (CT) being the main modality. For positioning verification, 2D IGPT was more commonly used than 3D IGPT. Two centres performed routinely imaging for plan adaptation, by the rest ad hoc. Eight centres participated in the Delphi consensus analysis. The full consensus was reached on the use of CT imaging without contrast for treatment planning and the role of magnetic resonance imaging (MRI) in target and organs-at-risk delineation. There was an agreement on the necessity to perform patient position verification and correction before each isocentre. The most important outcome was the clear need for standardization and harmonization of the workflow. CONCLUSION There were differences in CSI IGPT clinical practice among the European particle therapy centres. Moreover, the optimal workflow as identified by experts was not yet reached. There is a strong need for consensus guidelines. The state-of-the-art imaging technology and protocols need to be implemented into clinical practice to improve the quality of IGPT for CSI.
Collapse
Affiliation(s)
- Petra Trnková
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria.
| | - Alexandru Dasu
- The Skandion Clinic, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Lorenzo Placidi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Rome, Italy
| | - Markus Stock
- MedAustron Ion Therapy Centre, Wiener Neustadt, Austria; Karl Landsteiner University of Health Sciences, Wiener Neustadt, Austria
| | - Iuliana Toma-Dasu
- Medical Radiation Physics, Department of Physics, Stockholm University, Stockholm, Sweden; Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - Charlotte L Brouwer
- University of Groningen, University Medical Centre Groningen, Department of Radiation Oncology, the Netherlands
| | - Andrew Gosling
- Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - Emmanuel Jouglar
- Department of Radiation Oncology, Institute Curie, PSL Research University, Orsay, Paris, France
| | - Ingrid Kristensen
- Radiation Physics, Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, Sweden
| | - Valentine Martin
- Department of Radiation Oncology, Institute Gustave Roussy, Villejuif, France
| | - Syed Moinuddin
- Department of Radiotherapy, University College London Hospitals NHS Foundation Trust, London, UK
| | - Isabelle Pasquie
- Department of Radiation Oncology, Institute Curie, PSL Research University, Orsay, Paris, France
| | - Sarah Peters
- Department of Particle Therapy, University Hospital Essen, Germany; West German Proton Therapy Centre Essen (WPE), Essen, Germany
| | - Alessia Pica
- Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Sandija Plaude
- West German Proton Therapy Centre Essen (WPE), Essen, Germany
| | - Roberto Righetto
- Medical Physics Unit, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Barbara Rombi
- Proton Therapy Unit, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Juliette Thariat
- Department of Radiotherapy, Centre François Baclesse, Caen, France
| | - Hiske van der Weide
- University of Groningen, University Medical Centre Groningen, Department of Radiation Oncology, the Netherlands
| | - Aswin Hoffmann
- OncoRay - National Centre for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany; Department of Radiotherapy and Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Alessandra Bolsi
- Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| |
Collapse
|
2
|
Zaghloul MS, Hunter A, Mostafa AG, Parkes J. Re-irradiation for recurrent/progressive pediatric brain tumors: from radiobiology to clinical outcomes. Expert Rev Anticancer Ther 2023; 23:709-717. [PMID: 37194207 DOI: 10.1080/14737140.2023.2215439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/15/2023] [Indexed: 05/18/2023]
Abstract
INTRODUCTION Brain tumors are the most common solid tumors in children. Neurosurgical excision, radiotherapy, and/or chemotherapy represent the standard of care in most histopathological types of pediatric central nervous system (CNS) tumors. Even though the successful cure rate is reasonable, some patients may develop recurrence locally or within the neuroaxis. AREA COVERED The management of these recurrences is not easy; however, significant advances in neurosurgery, radiation techniques, radiobiology, and the introduction of newer biological therapies, have improved the results of their salvage treatment. In many cases, salvage re-irradiation is feasible and has achieved encouraging results. The results of re-irradiation depend upon several factors. These factors include tumor type, extent of the second surgery, tumor volume, location of the recurrence, time that elapses between the initial treatment, the combination with other treatment agents, relapse, and the initial response to radiotherapy. EXPERT OPINION Reviewing the radiobiological basis and clinical outcome of pediatric brain re-irradiation revealed that re-irradiation is safe, feasible, and indicated for recurrent/progressive different tumor types such as; ependymoma, medulloblastoma, diffuse intrinsic pontine glioma (DIPG) and glioblastoma. It is now considered part of the treatment armamentarium for these patients. The challenges and clinical results in treating recurrent pediatric brain tumors were highly documented.
Collapse
Affiliation(s)
- Mohamed S Zaghloul
- Radiation Oncology department. National Cancer Institute, Cairo University & Children's Cancer Hospital, Cairo, Egypt
| | - Alistair Hunter
- Division of Radiobiology, Radiation Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Ayatullah G Mostafa
- Department of Radiology, Faculty of Medicine, Egypt and Department of Diagnostic Imaging, Cairo University, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jeannette Parkes
- Radiation Oncology Department, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| |
Collapse
|