Present developments in reaching an international consensus for a model-based approach to particle beam therapy

Anussara Prayongrat, Kikuo Umegaki, Arjen Van Der Schaaf, Albert C. Koong, Steven H. Lin, Thomas Whitaker, Todd McNutt, Naruhiro Matsufuji, Edward Graves, Masahiko Mizuta, Kazuhiko Ogawa, Hiroyuki Date, Kensuke Moriwaki, Yoichi M. Ito, Keiji Kobashi, Yasuhiro Dekura, Shinichi Shimizu, Hiroki Shirato

Research output: Contribution to journalArticle

Abstract

Particle beam therapy (PBT), including proton and carbon ion therapy, is an emerging innovative treatment for cancer patients. Due to the high cost of and limited access to treatment, meticulous selection of patients who would benefit most from PBT, when compared with standard X-ray therapy (XRT), is necessary. Due to the cost and labor involved in randomized controlled trials, the model-based approach (MBA) is used as an alternative means of establishing scientific evidence in medicine, and it can be improved continuously. Good databases and reasonable models are crucial for the reliability of this approach. The tumor control probability and normal tissue complication probability models are good illustrations of the advantages of PBT, but pre-existing NTCP models have been derived from historical patient treatments from the XRT era. This highlights the necessity of prospectively analyzing specific treatment-related toxicities in order to develop PBT-compatible models. An international consensus has been reached at the Global Institution for Collaborative Research and Education (GI-CoRE) joint symposium, concluding that a systematically developed model is required for model accuracy and performance. Six important steps that need to be observed in these considerations include patient selection, treatment planning, beam delivery, dose verification, response assessment, and data analysis. Advanced technologies in radiotherapy and computer science can be integrated to improve the efficacy of a treatment. Model validation and appropriately defined thresholds in a cost-effectiveness centered manner, together with quality assurance in the treatment planning, have to be achieved prior to clinical implementation.

Original languageEnglish (US)
Pages (from-to)i72-i76
JournalJournal of radiation research
Volume59
DOIs
StatePublished - Mar 1 2018

Keywords

  • GI-CoRE
  • model-based approach
  • normal tissue complication probability
  • particle beam therapy

ASJC Scopus subject areas

  • Radiation
  • Radiology Nuclear Medicine and imaging
  • Health, Toxicology and Mutagenesis

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    Prayongrat, A., Umegaki, K., Van Der Schaaf, A., Koong, A. C., Lin, S. H., Whitaker, T., McNutt, T., Matsufuji, N., Graves, E., Mizuta, M., Ogawa, K., Date, H., Moriwaki, K., Ito, Y. M., Kobashi, K., Dekura, Y., Shimizu, S., & Shirato, H. (2018). Present developments in reaching an international consensus for a model-based approach to particle beam therapy. Journal of radiation research, 59, i72-i76. https://doi.org/10.1093/jrr/rry008