WE‐G‐BRA‐09: Risk of Radiation‐Induced Secondary Cancers in Paediatric Patients: A Comparison of Intensity Modulated Proton Therapy and Intensity Modulated Radiotherapy
Bibliographic record
Abstract
Purpose: To determine secondary cancer risk in paediatric patients treated with intensity modulated proton radiation therapy (IMPT) compared to IMRT. Methods: Proton therapy plans were created for fifteen patients previously treated with photon beam IMRT. IMPT plans were planned using the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA) with a scanned proton beam model. The proton plans were planned to the same prescription dose as the photon plans. Each proton plan consisted of one to three fields, depending on tumour location, and photon plan constraints were used as a guide for IMPT constraints. Proton and photon plans were compared for dose conformity, homogeneity, volumes of tissue receiving low doses, integral dose, and second cancer induction risk. Second cancer risk was determined using two methods. The relative risk of secondary cancer was found by applying a linear relationship between integral dose and relative risk of secondary cancer. The second approach used the organ equivalent dose concept to describe the dose in the body and then calculate the excess absolute risk (EAR) for solid cancers. Results: IMPT and IMRT plans had similar target conformity, homogeneity, near minimum, near maximum and median doses however IMPT plans had reduced integral dose and volumes of the body receiving low dose. IMPT plans resulted in a 0.313±0.098 smaller relative risk of secondary cancer than IMRT plans. The EAR of secondary cancer in the body 30 years after treatment was reduced by 20.89±9.56, 24.30±8.46 and 22.91±7.91 patients per 10000 patients per year for the linear, linear exponential and plateau dose‐response models respectively in IMPT compared to IMRT plans. Conclusions: Two methods were used to determine the risk of secondary cancers following radiation therapy in paediatric patients. Both methods indicated that IMPT results in a lower risk of secondary cancer than photon beam IMRT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".