Comparing Proton to Photon Radiotherapy Plans: UK Consensus Guidance for Reporting Under Uncertainty for Clinical...

Area of Science:

• Medical Physics
• Radiation Oncology
• Clinical Trials

Background:

• The UK's adoption of high-energy proton beam therapy necessitates clinical trials comparing it with photon treatments.
• Proton therapy may reduce normal tissue dose but is sensitive to uncertainties like patient setup and beam range variations.
• Existing photon therapy safety methods, such as expansion margins, may not directly translate to proton therapy.

Purpose of the Study:

• To provide guidance for UK clinical trials comparing proton and photon beam therapy.
• To address the challenges associated with comparing different radiation therapy modalities.
• To introduce concepts and terms relevant to uncertainty analysis in proton therapy trials.

Main Methods:

• Overview of the effects of uncertainties on proton therapy plans.
• Introduction to key concepts and terminology for proton therapy trials.
• Development of a pragmatic consensus-based guidance for UK centres.

Main Results:

• Proton therapy plans require specific uncertainty evaluation and mitigation strategies distinct from photon therapy.
• Understanding and addressing discrepancies in patient setup and beam range are crucial for proton therapy safety.
• Guidance considers practical tools available to clinical centres.

Conclusions:

• Effective comparison of proton and photon therapy in clinical trials requires careful consideration of modality-specific uncertainties.
• Standardized approaches to uncertainty analysis are essential for ensuring the safety and efficacy of proton therapy.
• This guidance aims to facilitate robust UK clinical trials comparing proton and photon treatments.