PhD defence by Josefine Ståhl Kornerup – Niels Bohr Institute - University of Copenhagen

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PhD defence by Josefine Ståhl Kornerup

Paediatric photon and proton radiotherapy treatment planning based on advanced imaging

In this thesis, we study radiotherapy (RT) treatment planning in combination with the imaging technique positron emission tomography (PET). Specifically, we investigate the potential impact on the RT treatment plans of paediatric and adolescent cancer patients when combining the diagnostic information from PET with modern RT modalities.

We found that PET scanning can be added to the RT treatment planning of young cancer patients, with only a small increase of the diagnostic dose. We also found that adding PET to the RT treatment planning does not generally affect the RT doses to healthy organs or the ability of delivering adequate target volume dose. When studying the theoretical RT treatment plans for young patients with head and neck cancer, had their plans been generated without PET imaging, we found that plans generated for target volumes delineated without PET will result in inadequate doses to target volumes delineated with PET. Thus, if target volumes delineated with PET are more accurate, omitting PET from RT treatment planning will lead to severe under dosage of malignant tissue. Finally, we found that although RT with protons instead of photons may provide reduced irradiated volumes of healthy tissue and lower doses to healthy organs, these benefits cannot be taken for granted. If proton therapy requires slightly larger safety margins between tumour and RT field than photon RT, the dose-sparing benefits of proton RT may to some extent be lost.

Supervisors: Per Munck af Rosenschöld, RH; Thomas Björk-Eriksson, Sahlgrenska, Göteborg; Patrik Brodin, Albert Einstein Inst. New York; Annika Loft Jacobsen, RH

Opponents: Tommy Knöös, Medicinsk Strålningsfysik, Skåne Universitetssjukhus, Lund, Sverige; Frank Seran, Neuro-oncology, Royal Marsden, London, England; Thomas Døssing, NBI

Mediator: Poul Martin Bendix, NBI