Executive summary

This study used data of 92 patients treated with protons to create VMAT plans for comparison. NTCP differences were calculated for 11 models predicting brain necrosis, delayed recall, temporal lobe injury, hearing loss, tinnitus, blindness, ocular toxicity, cataract, endocrine dysfunction, alopecia, and erythema. If ΔNTCP exceeded a threshold of 10 percentage points for at least one of the side-effects, considering ΔNTCP of all models, 80 patients (87.0%) would have been selected for PBT in this in-silico study, mainly due to predictions of a model on delayed recall (51 patients). 

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