title: Establishing the feasibility of the dosimetric compliance criteria of RTOG 1308: phase III randomized trial comparing overall survival after photon versus proton radiochemotherapy for inoperable stage II-IIIB NSCLC.
abstract: BACKGROUND
  To establish the feasibility of the dosimetric compliance criteria of the RTOG 1308 trial through testing against Intensity Modulation Radiation Therapy (IMRT) and Passive Scattering Proton Therapy (PSPT) plans.
  
  
  METHODS
  Twenty-six lung IMRT and 26 proton PSPT plans were included in the study. Dose Volume Histograms (DVHs) for targets and normal structures were analyzed. The quality of IMRT plans was assessed using a knowledge-based engineering tool.
  
  
  RESULTS
  Most of the RTOG 1308 dosimetric criteria were achieved. The deviation unacceptable rates were less than 10 % for most criteria; however, a deviation unacceptable rate of more than 20 % was computed for the planning target volume minimum dose compliance criterion. Dose parameters for the target volume were very close for the IMRT and PSPT plans. However, the PSPT plans led to lower dose values for normal structures. The dose parameters in which PSPT plans resulted in lower values than IMRT plans were: lung V5Gy (%) (34.4 in PSPT and 47.2 in IMRT); maximum spinal cord dose (31.7 Gy in PSPT and 43.5 Gy in IMRT); heart V5Gy (%) (19 in PSPT and 47 in IMRT); heart V30Gy (%) (11 in PSPT and 19 in IMRT); heart V45Gy (%) (7.8 in PSPT and 12.1 in IMRT); heart V50% (Gy) (7.1 in PSPT and 9.8 in IMRT) and mean heart dose (7.7 Gy in PSPT and 14.9 Gy in IMRT).
  
  
  CONCLUSIONS
  The revised RTOG 1308 dosimetric compliance criteria are feasible and achievable.
authors.affiliation: Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. Tawfik.g.giaddui@jefferson.edu.
authors.forename: Tawfik
authors.initials: T
authors.lastname: Giaddui
authors.affiliation: Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Wenzhou
authors.initials: W
authors.lastname: Chen
authors.affiliation: Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Jialu
authors.initials: J
authors.lastname: Yu
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Liyong
authors.initials: L
authors.lastname: Lin
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Simone
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Lulin
authors.initials: L
authors.lastname: Yuan
authors.affiliation: Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Yutao U T
authors.initials: YU
authors.lastname: Gong
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Q Jackie
authors.initials: QJ
authors.lastname: Wu
authors.affiliation: MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Radhe
authors.initials: R
authors.lastname: Mohan
authors.affiliation: MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhang
authors.affiliation: MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Jaques B
authors.initials: JB
authors.lastname: Bluett
authors.affiliation: MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Gillin
authors.affiliation: University of California, San Diego, CA, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Moore
authors.affiliation: Imaging and Radiation Oncology Core (IROC) Philadelphia-RT QA Center, Philadelphia, PA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: O'Meara
authors.affiliation: Imaging and Radiation Oncology Core (IROC) Philadelphia-RT QA Center, Philadelphia, PA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Presley
authors.affiliation: Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Bradley
authors.affiliation: MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Zhongxing
authors.initials: Z
authors.lastname: Liao
authors.affiliation: Imaging and Radiation Oncology Core (IROC) Philadelphia-RT QA Center, Philadelphia, PA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Galvin
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Xiao
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D017785:Photons; D061766:Proton Therapy / Q000379:methods; D011785:Quality Assurance, Health Care; D011874:Radiometry / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*
keywords: Dosimetric criteria; IMRT; PSPT; Protons; RTOG 1308