Concept for individualized patient allocation: ReCompare—remote comparison of particle and photon treatment plans

Armin Lühr,Uwe Just,Klaus Roth,Mechthild Krause,Steffen Löck,Jørgen B Petersen,Michael Baumann,Wolfgang Enghardt,Annika Jakobi,Stephan Helmbrecht

doi:10.1186/1748-717x-9-59

Abstract

BackgroundIdentifying those patients who have a higher chance to be cured with fewer side effects by particle beam therapy than by state-of-the-art photon therapy is essential to guarantee a fair and sufficient access to specialized radiotherapy. The individualized identification requires initiatives by particle as well as non-particle radiotherapy centers to form networks, to establish procedures for the decision process, and to implement means for the remote exchange of relevant patient information. In this work, we want to contribute a practical concept that addresses these requirements.MethodsWe proposed a concept for individualized patient allocation to photon or particle beam therapy at a non-particle radiotherapy institution that bases on remote treatment plan comparison. We translated this concept into the web-based software tool ReCompare (REmote COMparison of PARticlE and photon treatment plans).ResultsWe substantiated the feasibility of the proposed concept by demonstrating remote exchange of treatment plans between radiotherapy institutions and the direct comparison of photon and particle treatment plans in photon treatment planning systems. ReCompare worked with several tested standard treatment planning systems, ensured patient data protection, and integrated in the clinical workflow.ConclusionsOur concept supports non-particle radiotherapy institutions with the patient-specific treatment decision on the optimal irradiation modality by providing expertise from a particle therapy center. The software tool ReCompare may help to improve and standardize this personalized treatment decision. It will be available from our website when proton therapy is operational at our facility.

Highlights

Identifying those patients who have a higher chance to be cured with fewer side effects by particle beam therapy than by state-of-the-art photon therapy is essential to guarantee a fair and sufficient access to specialized radiotherapy
For such cases, experienced personnel at the particle therapy center generate a particle therapy plan on the basis of the patient data accumulated at the non-particle radiotherapy institution, but with a different planning target volume (PTV) that considers the uncertainties at the particle therapy center
This concept implies the important aspect of cooperation and exchange between a non-particle radiotherapy institution and a particle therapy center, which is an integral part of a wellfounded decision on the different treatment options

Summary

Introduction

Identifying those patients who have a higher chance to be cured with fewer side effects by particle beam therapy than by state-of-the-art photon therapy is essential to guarantee a fair and sufficient access to specialized radiotherapy. The individualized identification requires initiatives by particle as well as non-particle radiotherapy centers to form networks, to establish procedures for the decision process, and to implement means for the remote exchange of relevant patient information. While the number of particle therapy centers worldwide increases steadily [1] the relative number of cancer patients who are treated with this technique—and may It is still subject of investigation on which criteria an attending physician should base a final decision regarding the treatment modality for an individual patient. One practical solution is a direct comparison of patientspecific dose distributions to discriminate between treatment options [2,3] This may include the application of available state-of-the-art tumor control probability and normal tissue complication probability models [4,5]. The identification of patients that benefit most from radiotherapy with particles requires initiatives by particle as well as non-particle radiotherapy centers to form networks, to establish a procedure for the decision process, and to implement means for the remote exchange of relevant patient information

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