Publications by authors named "B H Smulders"
Background And Purpose: As preparation for a national randomized study comparing proton radiotherapy to photon radiotherapy, DAHANCA 35, we performed a non-randomized pilot study to investigate patient selection, logistics, planning, and treatment delivery. With the present study, as a comprehensive safety analysis, we want to compare toxicity during and up to two months after therapy to a historically matched group of patients treated with photon radiotherapy.
Materials And Methods: 62 patients treated with protons were matched to 124 patients who received photon treatment outside a protocol.
Article Synopsis
- There is a slow adoption of daily cone-beam CT (CBCT) in pediatric image-guided radiotherapy (IGRT) compared to adults, with significant variations in protocol practices across centers.
- A survey involving 246 centers revealed responses from 50, highlighting that daily CBCT is commonly used, especially for brain/head and abdomen protocols, yet marked differences in technical settings and radiation doses exist.
- The study concludes that while daily CBCT usage is common, there is a need for standardization and optimization of pediatric IGRT protocols, as current research shows potential for dose reduction without compromising image quality.
Proton radiotherapy offers a dosimetric advantage compared to photon therapy in sparing normal tissue, but the clinical evidence for toxicity reductions in the treatment of head and neck cancer is limited. The Danish Head and Neck Cancer Group (DAHANCA) has initiated the DAHANCA 35 randomised trial to clarify the value of proton therapy (NCT04607694). The DAHANCA 35 trial is performed in an enriched population of patients selected by an anticipated benefit of proton therapy to reduce the risk of late dysphagia or xerostomia based on normal tissue complication probability (NTCP) modelling.
View Article and Find Full Text PDFBackground: In the Danish Head and Neck Cancer Group (DAHANCA) 35 trial, patients are selected for proton treatment based on simulated reductions of Normal Tissue Complication Probability (NTCP) for proton compared to photon treatment at the referring departments. After inclusion in the trial, immobilization, scanning, contouring and planning are repeated at the national proton centre. The new contours could result in reduced expected NTCP gain of the proton plan, resulting in a loss of validity in the selection process.
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