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Cancer Radiother. 2018 Dec;22(8):802-809. doi: 10.1016/j.canrad.2017.11.016. Epub 2018 Oct 13.

Concepts and terms for dose/volume parameters in carbon-ion radiotherapy: Conclusions of the ULICE taskforce.

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Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 54519 Vandœuvre-lès-Nancy cedex, France; CNRS, UMR 7365, ingénierie moléculaire et physiopathologie articulaire (Imopa), 54505 Vandœuvre-lès-Nancy cedex, France; Université de Lorraine, 54505 Vandoeuvre-lès-Nancy, France. Electronic address:
Institut de recherche expérimentale et clinique (Irec), Molecular Imaging, Radiotherapy and Oncology (MIRO), cliniques universitaires Saint-Luc, 1200 Brussels, Belgium; Université catholique de Louvain (UCL), 1348 Louvain-la-Neuve, Belgium.
Department of Radiotherapy, Comprehensive Cancer Center, Vienna, Austria; Medical University of Vienna, Vienna, Austria.
Université Lyon 1, 69100 Villeurbanne, France; Institut de physique nucléaire de Lyon, 69622 Villeurbanne cedex, France.
Klinik und Poliklinik für RadioOnkologie und Strahlentherapie, Technische Universität München (TUM), 81675 München, Germany; Instituts für Innovative Radiotherapie (iRT), Helmholtz Zentrum München, 85764 Oberschleißheim, Germany.
EBG MedAustron GmbH, 2700 Wiener-Neustadt, Austria.
Université Lyon 1, 69100 Villeurbanne, France; CNRS, UMR 5220 Laboratoire Creatis, 69100 Villeurbanne, France; Inserm, U1044 Laboratoire Creatis, 69100 Villeurbanne, France.
Università di Milano-Medicina e Chirurgia, Milano, Italy; Fondazione CNAO (Centro Nazionale di Adroterapia Oncologica), Pavia, Italy.
Service de cancérologie-radiothérapie, hôpital Albert-Michallon, CHU Grenoble Alpes, 38043 Grenoble cedex 09, France; IPNL, France Hadron national research infrastructure, 69000 Lyon, France; Université Grenoble Alpes, 38400 Saint-Martin-d'Hères, France.



The Union of Light Ion Centers in Europe (ULICE) program addressed the need for uniting scientific results for carbon-ion radiation therapy obtained by several institutions worldwide in different fields of excellence, and translating them into a real benefit to the community. Particularly, the concepts for dose/volume parameters developed in photon radiotherapy cannot be extrapolated to high linear energy transfer particles.


The ULICE-WP2 taskforce included radiation oncologists involved in carbon-ion radiation therapy and International Commission on Radiation Units and Measurements, radiation biologists, expert physicists in the fields of carbon-ion radiation therapy, microdosimetry, biological modeling and image-guided radiotherapy. Consensual reports emerged from multiple discussions within both the restricted group and the wider ULICE community. Public deliverables were produced and disseminated to the European Commission.


Here we highlight the disparity in practices between treating centers, then address the main topics to finally elaborate specific recommendations. Although it appears relatively simple to add geometrical margins around the clinical target volume to obtain the planning target volume as performed in photon radiotherapy, this procedure is not appropriate for carbon-ion radiation therapy. Due to the variation of the radiation quality in depth, there is no generic relative biological effectiveness value for carbon-ions outside of an isolated point, for a given fractionation and specific experimental conditions. Absorbed dose and "equieffective dose" for specified conditions must always be reported.


This work contributed to the development of standard operating procedures for carbon-ion radiation therapy clinical trials. These procedures are now being applied, particularly in the first phase III international, multicenter trial (PHRC Étoile).


Carbon-ion radiotherapy; Clinical trials; Dose isoefficace; Equieffective dose; Essai clinique; Hadronthérapie; Indication; Ions carbone; PTV; Prescription; Recording; Specification; Volume cible prévisionnel

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