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@ARTICLE{Knig:180137,
      author       = {L. König and J. Hörner-Rieber$^*$ and M. Forsthoefel and
                      P. Haering$^*$ and E. Meixner and T. Eichkorn and A. Krämer
                      and T. Mielke and E. Tonndorf-Martini and M. F. Haefner and
                      J. Debus$^*$ and J. W. Lischalk},
      title        = {{S}econdary {M}alignancy {R}isk {F}ollowing {P}roton vs.
                      {X}-ray {R}adiotherapy of {T}hymic {E}pithelial {T}umors:
                      {A} {C}omparative {M}odeling {S}tudy of {T}horacic
                      {O}rgan-{S}pecific {C}ancer {R}isk.},
      journal      = {Cancers},
      volume       = {14},
      number       = {10},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2022-01124},
      pages        = {2409},
      year         = {2022},
      abstract     = {Proton beam radiotherapy (PBT) offers physical dose
                      advantages that might reduce the risk for secondary
                      malignancies (SM). The aim of the current study is to
                      calculate the risk for SM after X-ray-based 3D conformal
                      (3DCRT) radiotherapy, intensity-modulated radiotherapy
                      (IMRT), and active pencil beam scanned proton therapy (PBS)
                      in patients treated for thymic malignancies.Comparative
                      treatment plans for each of the different treatment
                      modalities were generated for 17 patients. The risk for
                      radiation-induced SM was estimated using two distinct
                      prediction models-the Dasu and the Schneider model.The total
                      and fatal SM risks estimated using the Dasu model
                      demonstrated significant reductions with the use of PBS
                      relative to both 3DCRT and IMRT for all independent thoracic
                      organs analyzed with the exception of the thyroid gland (p
                      ≤ 0.001). SM rates per 10,000 patients per year per Gy
                      evaluated using the Schneider model also resulted in
                      significant reductions with the use of PBS relative to 3DCRT
                      and IMRT for the lungs, breasts, and esophagus (p ≤
                      0.001).PBS achieved superior sparing of relevant OARs
                      compared to 3DCRT and IMRT, leading to a lower risk for
                      radiation-induced SM. PBS should therefore be considered in
                      patients diagnosed with thymic malignancies, particularly
                      young female patients.},
      keywords     = {intensity-modulated radiotherapy (IMRT) (Other) / photon
                      radiotherapy (Other) / proton therapy (Other) /
                      radiation-induced cancers (Other) / thymic carcinoma (Other)
                      / thymoma (Other)},
      cin          = {E050 / E040 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331 / I:(DE-He78)E040-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35626013},
      doi          = {10.3390/cancers14102409},
      url          = {https://inrepo02.dkfz.de/record/180137},
}