Rotational arc treatments with static ports and dynamic collimation reduces cardiopulmonary dose for esophageal cancer patients and diminishes model-based predicted benefit of proton therapy.

ABSTRACT:

Background and purpose

Reducing dose to the lungs and heart is essential to minimize toxicity in esophageal cancer patients undergoing trimodality therapy. This study compared a new technique combining rotational arcs, static beam angles and dynamic collimation (RAD) against standard intensity-modulated radiotherapy (IMRT) and proton therapy (PT).

Materials and methods

RAD-plans were created for ten patients from the PROTECT trial who had high mean lung doses in their clinical IMRT-plan. For all techniques, optimization prioritized lung sparing. Predicted pulmonary complication risks were estimated using a validated NTCP-model. Comparisons were made between IMRT, RAD, and PT, and the impact on model-based PT-referral (ΔNTCP > 10 %) was assessed.

Results

RAD lowered me

SUBMITTER: Populaire P 

PROVIDER: S-EPMC12861950 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature