Dataset related to article: "Intensity modulated proton therapy compared to volumetric modulated arc therapy in the irradiation of young female patients with hodgkin's lymphoma. Assessment of risk of toxicity and secondary cancer induction"

This record contains data related to article: "Intensity modulated proton therapy compared to volumetric modulated arc therapy in the irradiation of young female patients with hodgkin's lymphoma. Assessment of risk of toxicity and secondary cancer induction" Abstract Background: To investigate the role of intensity modulated proton therapy (IMPT) compared to volumetric modulated arc therapy (VMAT) for advanced supradiaphragmatic Hodgkin's lymphoma (HL) in young female patients by assessing dosimetric features and modelling the risk of treatment related complications and radiation-induced secondary malignancies. Methods: A group of 20 cases (planned according to the involved-site approach) were retrospectively investigated in a comparative planning study. Intensity modulated proton plans (IMPT) were compared to VMAT RapidArc plans (RA). Estimates of toxicity were derived from normal tissue complication probability (NTCP) calculations with either the Lyman or the Poisson models for a number of endpoints. Estimates of the risk of secondary cancer induction were determined for lungs, breasts, esophagus and thyroid. A simple model-based selection strategy was considered as a feasibility proof for the individualized selection of patients suitable for proton therapy. Results: IMPT and VMAT plans resulted equivalent in terms of target dose distributions, both were capable to ensure high coverage and homogeneity. In terms of conformality, IMPT resulted ~ 10% better than RA plans. Concerning organs at risk, IMPT data presented a systematic improvement (highly significant) over RA for all organs, particularly in the dose range up to 20Gy. This lead to a composite average reduction of NTCP of 2.90 ± 2.24 and a reduction of 0.26 ± 0.22 in the relative risk of cardiac failures. The excess absolute risk per 10,000 patients-years of secondary cancer induction was reduced, with IMPT, of 9.1 ± 3.2, 7.2 ± 3.7 for breast and lung compared to RA. The gain in EAR for thyroid and esophagus was lower than 1. Depending on the arbitrary thresholds applied, the selection rate for proton treatment would have ranged from 5 to 75%. Conclusion: In relation to young female patients with advanced supradiaphragmatic HL, IMPT can in general offer improved dose-volume sparing of organs at risk leading to an anticipated lower risk of early or late treatment related toxicities. This would reflect also in significantly lower risk of secondary malignancies induction compared to advanced photon based techniques. Depending on the selection thresholds and with all the limits of a non-validated and very basic model, it can be anticipated that a significant fraction of patients might be suitable for proton treatments if all the risk factors would be accounted for.

本数据集关联以下学术论文：《调强质子治疗（Intensity Modulated Proton Therapy, IMPT）与容积调强弧形治疗（Volumetric Modulated Arc Therapy, VMAT）用于年轻女性霍奇金淋巴瘤（Hodgkin's Lymphoma, HL）患者照射的对比研究：毒性风险与继发性癌症诱导风险评估》
【研究背景】本研究旨在针对年轻女性晚期膈上型霍奇金淋巴瘤患者，对比调强质子治疗（IMPT）与容积调强弧形治疗（VMAT）的临床应用价值，通过评估剂量学特征，并建模分析治疗相关并发症及放射诱导继发性恶性肿瘤的发病风险。
【研究方法】本回顾性对比计划研究共纳入20例采用受累野照射方案的病例，开展调强质子治疗计划（IMPT）与VMAT快速弧治疗计划（RA）的对比分析。针对多项终点指标，分别采用利曼（Lyman）模型或泊松（Poisson）模型计算正常组织并发症概率（Normal Tissue Complication Probability, NTCP），以此推导毒性风险评估结果。同时针对肺、乳腺、食管及甲状腺器官，计算继发性癌症诱导的风险值。本研究还采用一种基于模型的简易筛选策略，作为个体化筛选适合质子治疗患者的可行性验证方案。
【研究结果】IMPT与VMAT计划的靶区剂量分布效果相当，二者均可实现较高的靶区覆盖度与均匀性。在适形度方面，IMPT计划较RA计划提升约10%。针对危及器官，IMPT计划对所有器官的剂量学参数均呈现出系统性且极具统计学意义的改善，尤其在20Gy以下的剂量区间效果更为显著。该优势使得整体平均NTCP值降低2.90±2.24，心脏衰竭相对风险降低0.26±0.22。相较于RA计划，IMPT可使每10000患者-年的继发性癌症超额绝对风险（Excess Absolute Risk, EAR）在乳腺与肺脏中分别降低9.1±3.2、7.2±3.7；在甲状腺与食管中，EAR的改善幅度则低于1。根据选取的任意阈值，质子治疗的适配患者筛选率可介于5%至75%之间。
【研究结论】针对年轻女性晚期膈上型HL患者，IMPT总体上可提升危及器官的剂量体积保护效果，从而降低治疗相关早期与晚期毒性反应的预期发生风险。相较于先进光子放疗技术，该方案还可显著降低继发性恶性肿瘤的诱导风险。尽管本研究采用的简易模型尚未经过验证且存在一定局限性，但根据筛选阈值的设定，若综合考量所有风险因素，预计有相当比例的患者可适配质子治疗方案。