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@ARTICLE{Eichkorn:180375,
author = {T. Eichkorn and C. Karger$^*$ and S. Brons and S. A.
Koerber and T. Mielke and T. Haberer and J. Debus$^*$ and K.
Herfarth},
title = {{R}esults of a prospective randomized trial on long-term
effectiveness of protons and carbon ions in prostate cancer:
{LEM} {I} and α/β=2{G}y overestimates the {RBE}.},
journal = {Radiotherapy and oncology},
volume = {173},
issn = {0167-8140},
address = {Amsterdam [u.a.]},
publisher = {Elsevier Science},
reportid = {DKFZ-2022-01289},
pages = {223-230},
year = {2022},
note = {2022 Jun 14;173:223-230},
abstract = {To analyze the long-term effectiveness of carbon ions
relative to protons in the prospective randomized controlled
ion prostate irradiation (IPI) trial.Effectiveness via PSA
assessment in a randomized study on prostate irradiation
with 20x3.3Gy(RBE) protons versus carbon ions was analyzed
in 92 patients. Proton RBE was based on a fixed RBE of 1.1
while the local effect model (LEM) I and an α/β=2Gy was
used for carbon ions. The dose in the prostate was
recalculated based on the delivered treatment plan using LEM
I and LEM IV and different α/β values.Five-year overall
and progression free survival was $98\%$ and $85\%$ with
protons and $91\%$ and $50\%$ with carbon ions,
respectively, with the latter being unexpectedly low
compared to Japanese carbon ion data and rather
corresponding to a photon dose <72 Gy in 2 Gy fractions.
According to LEM I and the applied α/β-value of 2Gy, the
applied carbon ion dose in 2 Gy(RBE) fractions (EQD2) was
87.46 Gy(RBE). Recalculations confirmed a strong dependence
of RBE-weighted dose on the α/β ratio as well as on the
RBE-model.The data demonstrate a significant lower
effectiveness of the calculated RBE-weighted dose in the
carbon ion as compared to the proton arm. LEM I and an α/β
= 2 Gy overestimates the RBE for carbon ions in prostate
cancer treatment. Adjusting the biological dose calculation
by using LEM I with α/β=4 Gy could be a pragmatic way to
safely escalate dose in carbon ion radiotherapy for prostate
cancer.},
keywords = {Carbon ion and proton radiotherapy (Other) / Local effect
model (LEM) (Other) / Prostate cancer (Other) / Relative
biological effectiveness (RBE) (Other) / α/β ratio
(Other)},
cin = {E040 / E050 / HD01},
ddc = {610},
cid = {I:(DE-He78)E040-20160331 / I:(DE-He78)E050-20160331 /
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:35714806},
doi = {10.1016/j.radonc.2022.06.006},
url = {https://inrepo02.dkfz.de/record/180375},
}