Establishing the feasibility of the dosimetric compliance criteria of RTOG 1308: phase III randomized trial comparing overall survival after photon versus proton radiochemotherapy for inoperable stage II-IIIB NSCLC

• Authors: Tawfik Giaddui, Thomas Jefferson University; Wenzhou Chen, Thomas Jefferson University; Jialu Yu, Thomas Jefferson University; Liyong Lin, Emory University; Charles B. Simone, University of Pennsylvania; Lulin Yuan, Duke University; Yutao U. T. Gong, Thomas Jefferson University; Q. Jackie Wu, Duke University; Radhe Mohan, MD Anderson Cancer Center; Xiaodong Zhang, Emory University; Jaques B. Bluett, MD Anderson Cancer Center; Michael Gillin, MD Anderson Cancer Center; Kevin Moore, University of California San Diego; Elizabeth O'Meara, Imaging & Radiat Oncol Core IROC Philadelphia RT; Jennifer Presley, Imaging & Radiat Oncol Core IROC Philadelphia RT; Jeffrey D. Bradley, Washington University; Zhongxing Liao, MD Anderson Cancer Center; James Galvin, Imaging and Radiation Oncology Core; Ying Xiao, University of Pennsylvania
• Journal Title: Radiation Oncology
• Volume: Volume 11, Number 1
• Publisher: BMC (part of Springer Nature) | 2016-05-04, Pages 66-66
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/s13014-016-0640-8
• Subjects: Health Sciences, Oncology; Health Sciences, Radiology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; Radiology, Nuclear Medicine & Medical Imaging; RTOG 1308; Dosimetric criteria; IMRT; Protons; PSPT; CELL LUNG-CANCER; IMRT PLANS; RADIATION; RADIOTHERAPY; QUALITY; THERAPY; TOOL

Abstract

Background: To establish the feasibility of the dosimetric compliance criteria of the RTOG 1308 trial through testing against Intensity Modulation Radiation Therapy (IMRT) and Passive Scattering Proton Therapy (PSPT) plans. Methods: Twenty-six lung IMRT and 26 proton PSPT plans were included in the study. Dose Volume Histograms (DVHs) for targets and normal structures were analyzed. The quality of IMRT plans was assessed using a knowledge-based engineering tool. Results: Most of the RTOG 1308 dosimetric criteria were achieved. The deviation unacceptable rates were less than 10 % for most criteria; however, a deviation unacceptable rate of more than 20 % was computed for the planning target volume minimum dose compliance criterion. Dose parameters for the target volume were very close for the IMRT and PSPT plans. However, the PSPT plans led to lower dose values for normal structures. The dose parameters in which PSPT plans resulted in lower values than IMRT plans were: lung V5Gy(%) (34.4 in PSPT and 47.2 in IMRT); maximum spinal cord dose (31.7 Gy in PSPT and 43.5 Gy in IMRT); heart V5Gy(%) (19 in PSPT and 47 in IMRT); heart V30Gy(%) (11 in PSPT and 19 in IMRT); heart V45Gy(%) (7.8 in PSPT and 12.1 in IMRT); heart V50%(Gy) (7.1 in PSPT and 9.8 in IMRT) and mean heart dose (7.7 Gy in PSPT and 14.9 Gy in IMRT). Conclusions: The revised RTOG 1308 dosimetric compliance criteria are feasible and achievable.