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@ARTICLE{Srensen:170525,
      author       = {B. S. Sørensen and J. Pawelke and J. Bauer and N. G.
                      Burnet and A. Dasu and M. Høyer and C. P. Karger$^*$ and M.
                      Krause$^*$ and M. Schwarz and T. S. A. Underwood and D.
                      Wagenaar and G. A. Whitfield and A. Lühr},
      title        = {{D}oes the uncertainty in relative biological effectiveness
                      affect patient treatment in proton therapy?},
      journal      = {Radiotherapy and oncology},
      volume       = {163},
      issn         = {0167-8140},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2021-01984},
      pages        = {177-184},
      year         = {2021},
      note         = {2021 Sep 1;163:177-184},
      abstract     = {Clinical treatment with protons uses the concept of
                      relative biological effectiveness (RBE) to convert the
                      absorbed dose into an RBE-weighted dose that equals the dose
                      for radiotherapy with photons causing the same biological
                      effect. Currently, in proton therapy a constant RBE of 1.1
                      is generically used. However, empirical data indicate that
                      the RBE is not constant, but increases at the distal edge of
                      the proton beam. This increase in RBE is of concern, as the
                      clinical impact is still unresolved, and clinical studies
                      demonstrating a clinical effect of an increased RBE are
                      emerging. Within the European Particle Therapy Network
                      (EPTN) work package 6 on radiobiology and RBE, a workshop
                      was held in February 2020 in Manchester with one day of
                      discussion dedicated to the impact of proton RBE in a
                      clinical context. Current data on RBE effects, patient
                      outcome and modelling from experimental as well as clinical
                      studies were presented and discussed. Furthermore,
                      representatives from European clinical proton therapy
                      centres, who were involved in patient treatment, laid out
                      their current clinical practice on how to consider the risk
                      of a variable RBE in their centres. In line with the
                      workshop, this work considers the actual impact of RBE
                      issues on patient care in proton therapy by reviewing
                      preclinical data on the relation between linear energy
                      transfer (LET) and RBE, current clinical data sets on RBE
                      effects in patients, and applied clinical strategies to
                      manage RBE uncertainties. A better understanding of the
                      variability in RBE would allow development of proton
                      treatments which are safer and more effective.},
      subtyp        = {Review Article},
      cin          = {E040 / DD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E040-20160331 / I:(DE-He78)DD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34480959},
      doi          = {10.1016/j.radonc.2021.08.016},
      url          = {https://inrepo02.dkfz.de/record/170525},
}