ESTRO PT 2018

Table 1: Comparison of mean target coverage and dose to organs at risk of proton therapy with 3DCRT, Tomotherapy, and VMAT (n = 10)

Treatment Technique

(A-B)

(A-C)

(A-D)

Target/Dose

Proton (A)

3DCRT (B)

p-value

Tomotherapy (C)

p-value

VMAT (D)

p-value

CTV minus skin V(50.4 Gy(RBE) )

96.6 ± 0.72 99.6 ± 0.14 99.9 ± 0.06

79.6 ± 4.30 92.0 ± 1.27 95.4 ± 0.51

96.6 ± 1.41 99.3 ± 0.42 99.8 ± 0.18

94.3 ± 1.21 99.0 ± 0.45 99.8 ± 0.20

<0.001

0.975

0.017

V(47.9

)

<0.001

0.240

0.039

Gy(RBE)

V(45.4

)

<0.001

0.097

0.129

Gy(RBE)

PTV minus skin V(50.4 Gy(RBE) )

81.9 ± 2.36 91.6 ± 1.56 95.8 ± 0.74

69.2 ± 4.02 86.5 ± 1.87 92.2 ± 0.78

88.1 ± 1.94 94.8 ± 0.74 96.9 ± 0.41

85.8 ± 1.36 95.6 ± 0.98 98.4 ± 0.46

<0.001

0.004

0.023

V(47.9

)

0.004

0.011

0.006

Gy(RBE)

V(45.4

)

0.003

0.044

0.002

Gy(RBE)

IMN CTV V(50.4

96.9 ± 3.22 99.5 ± 0.71 99.9 ± 0.16 54.1 ± 1.14

75.3 ± 11.87 85.4 ± 8.94 89.6 ± 8.23 51.4 ± 2.77

99.5 ± 0.66 91.0 ± 17.66 100.0 ± 0.00 53.5 ± 0.58

93.7 ± 3.62 99.1 ± 1.18 99.8 ± 0.36 52.6 ± 0.35

)

0.003

0.174

0.202

Gy(RBE)

V(47.9

)

0.013

0.374

0.670

Gy(RBE)

V(45.4

)

0.037

0.259

0.678

Gy(RBE)

0.069 Note: Benefit persisted of Protons WITH inclusion of IMN over photon plans WITHOUT IMN inclusion. 0.338 40.4 ± 2.78 53.3 ± 3.45 66.4 ± 4.03 <0.001 25.2 ± 2.17 36.3 ± 4.25 58.6 ± 5.87 0.033 27.3 ± 1.22 40.6 ± 1.55 58.0 ± 11.59 <0.001 0.852 <0.001 <0.001

Mean dose

0.015

Gy(RBE)

Left lung V(20

28.4 ± 3.23 35.9 ± 3.79 41.3 ± 4.10

)

0.518

Gy(RBE)

V(10

)

0.052

Gy(RBE)

V(5

)

0.013

Gy(RBE)

Right lung V(20

0.04 ± 0.04 0.1 ± 0.09 0.3 ± 0.21

0.1 ± 0.10 0.4 ± 0.20 0.7 ± 0.34

0.2 ± 0.19 5.8 ± 2.15 34.4 ± 6.04

4.1 ± 3.16 19.8 ± 7.76 45.1 ± 7.36

)

0.148

0.129

0.033

Gy(RBE)

V(10

)

0.058

0.001

0.001

Gy(RBE)

V(5

)

0.047

<0.001

<0.001

Gy(RBE)

Both lungs V(20

13.5 ± 1.63 16.9 ± 1.82 19.5 ± 2.00

19.2 ± 1.63 25.2 ± 1.87 31.5 ± 2.17

12.1 ± 1.16 20.0 ± 1.94 45.3 ± 3.38

15.2 ± 2.17 29.7 ± 4.03 54.0 ± 4.57

)

<0.001

0.038

0.046

Gy(RBE)

V(10

)

<0.001

0.001

<0.001

Gy(RBE)

V(5

)

<0.001

<0.001

<0.001

Gy(RBE)

Heart

1.2 ± 0.42 1.2 ± 0.64

6.8 ± 2.08 6.3 ± 3.96

10.2 ± 1.60 7.9 ± 2.74

8.2 ± 1.13 7.4 ± 7.08

Mean dose

<0.001

<0.001

<0.001

Gy(RBE)

V(25

)

0.016

<0.001

0.114

Gy(RBE)

19