Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons
Radiation therapy (RT) is an effective treatment for stage IIA and select stage IIB seminomas. However, given the long life expectancy of seminoma patients, there are concerns about the risk of secondary cancers from RT. This study assessed differences in secondary cancer risk for stage II seminoma...
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| Format: | Article |
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MDPI AG
2024-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/4/784 |
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| author | Jennifer Pursley Kyla Remillard Nicolas Depauw Grace Lee Clemens Grassberger Harald Paganetti Jason A. Efstathiou Sophia C. Kamran |
| author_facet | Jennifer Pursley Kyla Remillard Nicolas Depauw Grace Lee Clemens Grassberger Harald Paganetti Jason A. Efstathiou Sophia C. Kamran |
| author_sort | Jennifer Pursley |
| collection | DOAJ |
| description | Radiation therapy (RT) is an effective treatment for stage IIA and select stage IIB seminomas. However, given the long life expectancy of seminoma patients, there are concerns about the risk of secondary cancers from RT. This study assessed differences in secondary cancer risk for stage II seminoma patients following proton pencil-beam scanning (PBS) and photon VMAT, compared to 3D conformal photon RT. Ten seminoma patients, five with a IIA staging who received 30 GyRBE and five with a IIB staging who received 36 GyRBE, had three RT plans generated. Doses to organs at risk (OAR) were evaluated, and secondary cancer risks were calculated as the Excess Absolute Risk (EAR) and Lifetime Attributable Risk (LAR). PBS reduced the mean OAR dose by 60% on average compared to 3D, and reduced the EAR and LAR for all OAR, with the greatest reductions seen for the bowel, liver, and stomach. VMAT reduced high doses but increased the low-dose bath, leading to an increased EAR and LAR for some OAR. PBS provided superior dosimetric sparing of OAR compared to 3D and VMAT in stage II seminoma cases, with models demonstrating that this may reduce secondary cancer risk. Therefore, proton therapy shows the potential to reduce acute and late side effects of RT for this population. |
| first_indexed | 2024-03-07T22:39:00Z |
| format | Article |
| id | doaj.art-c49ec5b5eaab483d974e7e581401296f |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-07T22:39:00Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c49ec5b5eaab483d974e7e581401296f2024-02-23T15:11:13ZengMDPI AGCancers2072-66942024-02-0116478410.3390/cancers16040784Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D PhotonsJennifer Pursley0Kyla Remillard1Nicolas Depauw2Grace Lee3Clemens Grassberger4Harald Paganetti5Jason A. Efstathiou6Sophia C. Kamran7Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USADepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USADepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USADepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USADepartment of Radiation Oncology, University of Washington Medical Center, Seattle, WA 98195, USADepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USADepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USADepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USARadiation therapy (RT) is an effective treatment for stage IIA and select stage IIB seminomas. However, given the long life expectancy of seminoma patients, there are concerns about the risk of secondary cancers from RT. This study assessed differences in secondary cancer risk for stage II seminoma patients following proton pencil-beam scanning (PBS) and photon VMAT, compared to 3D conformal photon RT. Ten seminoma patients, five with a IIA staging who received 30 GyRBE and five with a IIB staging who received 36 GyRBE, had three RT plans generated. Doses to organs at risk (OAR) were evaluated, and secondary cancer risks were calculated as the Excess Absolute Risk (EAR) and Lifetime Attributable Risk (LAR). PBS reduced the mean OAR dose by 60% on average compared to 3D, and reduced the EAR and LAR for all OAR, with the greatest reductions seen for the bowel, liver, and stomach. VMAT reduced high doses but increased the low-dose bath, leading to an increased EAR and LAR for some OAR. PBS provided superior dosimetric sparing of OAR compared to 3D and VMAT in stage II seminoma cases, with models demonstrating that this may reduce secondary cancer risk. Therefore, proton therapy shows the potential to reduce acute and late side effects of RT for this population.https://www.mdpi.com/2072-6694/16/4/784testicular seminomaproton therapysecondary cancer modeling |
| spellingShingle | Jennifer Pursley Kyla Remillard Nicolas Depauw Grace Lee Clemens Grassberger Harald Paganetti Jason A. Efstathiou Sophia C. Kamran Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons Cancers testicular seminoma proton therapy secondary cancer modeling |
| title | Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons |
| title_full | Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons |
| title_fullStr | Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons |
| title_full_unstemmed | Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons |
| title_short | Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons |
| title_sort | radiation therapy for stage iia b seminoma modeling secondary cancer risk for protons and vmat versus 3d photons |
| topic | testicular seminoma proton therapy secondary cancer modeling |
| url | https://www.mdpi.com/2072-6694/16/4/784 |
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