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dc.contributor.authorDale, Jon Espenen_US
dc.contributor.authorMolinelli, Silviaen_US
dc.contributor.authorVitolo, Vivianaen_US
dc.contributor.authorVischioni, Barbaraen_US
dc.contributor.authorBonora, Mariaen_US
dc.contributor.authorMagro, Giuseppeen_US
dc.contributor.authorPettersen, Helge Egil Seimeen_US
dc.contributor.authorMairani, Andreaen_US
dc.contributor.authorHasegawa, Azusaen_US
dc.contributor.authorDahl, Olaven_US
dc.contributor.authorValvo, Francescaen_US
dc.contributor.authorFossati, Pieroen_US
dc.date.accessioned2020-05-14T11:41:38Z
dc.date.available2020-05-14T11:41:38Z
dc.date.issued2019
dc.PublishedDale JE, Molinelli S, Vitolo V, Vischioni, Bonora M, Magro G, Pettersen HES, Mairani A, Hasegawa, Dahl O, Valvo, Fossati P. Optic nerve constraints for carbon ion RT at CNAO ? Reporting and relating outcome to European and Japanese RBE. Radiotherapy and Oncology. 2019;140:175-181eng
dc.identifier.issn0167-8140
dc.identifier.issn1879-0887
dc.identifier.urihttps://hdl.handle.net/1956/22264
dc.description.abstractBackground and purpose: Until now, carbon ion RT (CIRT) dose constraints for the optic nerve (ON) have only been validated and reported in the NIRS RBE-weighted dose (DNIRS). The aim of this work is to improve CNAO’s RBE-weighted dose (DLEM) constraints by analyzing institutional toxicity data and by relating it to DNIRS. Material and methods: A total of 65 ONs from 38 patients treated with CIRT to the head and neck region in the period 2013–14 were analyzed. The absorbed dose (DAbs) of the treatment plans was reproduced and subsequently both DLEM and DNIRS were applied, thus relating CNAO clinical toxicity to DNIRS. Results: Median FU was 47 (26–67) months. Visual acuity was preserved for the 56 ONs in which the old constraints were respected. Three ONs developed visual decline at DLEM|1% ≥71 Gy(RBE)/DLEM|20% ≥68 Gy(RBE), corresponding to DNIRS|1% ≥68 Gy(RBE)/DNIRS|20% ≥62 Gy(RBE). Dose recalculation revealed that NIRS constraints of DNIRS|1% ≤40 Gy(RBE)/DNIRS|20% ≤28 Gy(RBE) corresponded to DLEM|1% ≤50 Gy(RBE)/DLEM|20% ≤40 Gy(RBE). Reoptimization of treatment plans with these new DLEM constraints showed that the dose distribution still complied with NIRS constraints when evaluated in DNIRS. However, due to uncertainties in the method, and to comply with the EQD2-based constraints used at GSI/HIT, a more moderate constraint relaxation to DLEM|1% ≤45 Gy(RBE)/DLEM|20% ≤37 Gy(RBE) has been implemented in CNAO clinical routine since October 2018. Conclusion: New DLEM constraints for the ON were derived by analyzing CNAO toxicity data and by linking our results to the experience of NIRS and GSI/HIT. This work demonstrates the value of recalculating and reporting results in both DLEM and DNIRS.en_US
dc.language.isoengeng
dc.publisherElseviereng
dc.rightsAttribution-NonCommercial-NoDerivs CC BY-NC-NDeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/eng
dc.titleOptic nerve constraints for carbon ion RT at CNAO ? Reporting and relating outcome to European and Japanese RBEen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2020-01-23T08:32:20Z
dc.description.versionacceptedVersionen_US
dc.rights.holderCopyright 2019 Elsevier
dc.identifier.doihttps://doi.org/10.1016/j.radonc.2019.06.028
dc.identifier.cristin1721081
dc.source.journalRadiotherapy and Oncology
dc.source.pagenumber175-181
dc.identifier.citationRadiotherapy and Oncology. 2019;140:175-181
dc.source.volume140


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