Ways to unravel the clinical potential of carbon ions for head and neck cancer reirradiation: dosimetric comparison and local failure pattern analysis as part of the prospective randomized CARE trial

BACKGROUND: Carbon ion radiotherapy (CIRT) yields biophysical advantages compared to photons but randomized studies for the reirradiation setting are pending. The aim of the current project was to evaluate potential clinical benefits and drawbacks of CIRT compared to volumetric modulated arc therapy...

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Hauptverfasser: Held, Thomas (VerfasserIn) , Tessonnier, Thomas (VerfasserIn) , Franke, Henrik (VerfasserIn) , Regnery, Sebastian (VerfasserIn) , Bauer, Lukas (VerfasserIn) , Kozyra, Katharina (VerfasserIn) , Harrabi, Semi B. (VerfasserIn) , Herfarth, Klaus (VerfasserIn) , Mairani, Andrea (VerfasserIn) , Debus, Jürgen (VerfasserIn) , Adeberg, Sebastian (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 8 July 2022
In: Radiation oncology
Year: 2022, Jahrgang: 17, Pages: 1-12
ISSN:1748-717X
DOI:10.1186/s13014-022-02093-4
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1186/s13014-022-02093-4
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Verfasserangaben:Thomas Held, Thomas Tessonnier, Henrik Franke, Sebastian Regnery, Lukas Bauer, Katharina Weusthof, Semi Harrabi, Klaus Herfarth, Andrea Mairani, Jürgen Debus and Sebastian Adeberg

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520 |a BACKGROUND: Carbon ion radiotherapy (CIRT) yields biophysical advantages compared to photons but randomized studies for the reirradiation setting are pending. The aim of the current project was to evaluate potential clinical benefits and drawbacks of CIRT compared to volumetric modulated arc therapy (VMAT) in recurrent head and neck cancer. - METHODS: Dose-volume parameters and local failure patterns of CIRT compared to VMAT were evaluate in 16 patients from the randomized CARE trial on head and neck cancer reirradiation. - RESULTS: Despite an increased target dose, CIRT resulted in significantly reduced organ at risk (OAR) dose across all patients (- 8.7% Dmean). The dose-volume benefits were most pronounced in the brainstem (- 20.7% Dmax) and the optic chiasma (- 13.0% Dmax). The most frequent local failure was type E (extraneous; 50%), followed type B (peripheral; 33%) and type A (central; 17%). In one patient with type A biological and/or dosimetric failure after CIRT, mMKM dose recalculation revealed reduced target coverage. - CONCLUSIONS: CIRT resulted in highly improved critical OAR sparing compared to VMAT across all head and neck cancer reirradiation scenarios despite an increased prescription dose. Local failure pattern analysis revealed further potential CIRT specific clinical benefits and potential pitfalls with regard to image-guidance and biological dose-optimization. 
650 4 |a Carbon 
650 4 |a Carbon ion radiotherapy 
650 4 |a Dosimetric analysis 
650 4 |a Head and neck cancer 
650 4 |a Head and Neck Neoplasms 
650 4 |a Heavy ions 
650 4 |a Humans 
650 4 |a Ions 
650 4 |a Local control 
650 4 |a Neoplasm Recurrence, Local 
650 4 |a Pattern of failure 
650 4 |a Prospective Studies 
650 4 |a Radiotherapy Dosage 
650 4 |a Radiotherapy, Intensity-Modulated 
650 4 |a Randomized Controlled Trials as Topic 
650 4 |a Re-Irradiation 
650 4 |a Re-radiotherapy 
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650 4 |a Squamous cell carcinoma 
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