Derivation of mean dose tolerances for new fractionation schemes and treatment modalities

Physics in Medicine and Biology
Zoltán PerkóJan Unkelbach

Abstract

Avoiding toxicities in radiotherapy requires the knowledge of tolerable organ doses. For new, experimental fractionation schemes (e.g. hypofractionation) these are typically derived from traditional schedules using the biologically effective dose (BED) model. In this report we investigate the difficulties of establishing mean dose tolerances that arise since the mean BED depends on the entire spatial dose distribution, rather than on the dose level alone. A formula has been derived to establish mean physical dose constraints such that they are mean BED equivalent to a reference treatment scheme. This formula constitutes a modified BED equation where the influence of the spatial dose distribution is summarized in a single parameter, the dose shape factor. To quantify effects we analyzed 24 liver cancer patients for whom both proton and photon IMRT treatment plans were available. The results show that the standard BED equation-neglecting the spatial dose distribution-can overestimate mean dose tolerances for hypofractionated treatments by up to 20%. The shape difference between photon and proton dose distributions can cause 30-40% differences in mean physical dose for plans having identical mean BEDs. Converting hypofractionated,...Continue Reading

References

Sep 1, 1991·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·J V Lebesque, R B Keus
Apr 1, 1990·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·J C Flickinger, A Kalend
Jun 1, 1989·International Journal of Radiation Oncology, Biology, Physics·G J Kutcher, C Burman
Nov 1, 1983·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·H R WithersL J Peters
Nov 1, 1982·International Journal of Radiation Oncology, Biology, Physics·G W Barendsen
Oct 1, 1994·Cancer Treatment Reviews·L Moonen, H Bartelink
Jan 1, 1993·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·C H NewcombR P Hill
Mar 17, 1999·International Journal of Radiation Oncology, Biology, Physics·R G Dale, B Jones
Jul 4, 2002·International Journal of Radiation Oncology, Biology, Physics·Laura A DawsonRandall K Ten Haken
Nov 16, 2002·Physics in Medicine and Biology·Beong Choi, Joseph O Deasy
Feb 8, 2003·International Journal of Radiation Oncology, Biology, Physics·Yvette SeppenwooldeRandall K Ten Haken
Jan 31, 2004·Seminars in Radiation Oncology·Laura A Dawson, James M Balter
Mar 6, 2004·International Journal of Radiation Oncology, Biology, Physics·Wolfgang A Tomé, John D Fenwick
Sep 3, 2004·Nature Reviews. Cancer·Jacques BernierAmato Giaccia
Oct 7, 2004·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·T RancatiR Valdagni
May 14, 2005·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Jose BelderbosJoos Lebesque
Jun 7, 2005·International Journal of Radiation Oncology, Biology, Physics·Clinton S ParkPing Xia
Nov 1, 2005·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Olivier ChapetRandall K Ten Haken
Sep 20, 2006·Acta Oncologica·Laura A DawsonTim Craig
Sep 11, 2007·Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)·Hiram A Gay, Andrzej Niemierko
Jan 10, 2008·Physics in Medicine and Biology·Gary LuxtonChristopher R King
Aug 30, 2008·Seminars in Radiation Oncology·John P KirkpatrickLawrence B Marks
Mar 18, 2009·International Journal of Radiation Oncology, Biology, Physics·An TaiX Allen Li
Mar 5, 2010·International Journal of Radiation Oncology, Biology, Physics·Lawrence B MarksMary K Martel
Mar 5, 2010·International Journal of Radiation Oncology, Biology, Physics·Søren M BentzenBarry S Rosenstein
Mar 5, 2010·International Journal of Radiation Oncology, Biology, Physics·Lawrence B MarksAndrew Jackson
Mar 5, 2010·International Journal of Radiation Oncology, Biology, Physics·Charlie C PanRandall K Ten Haken
Apr 29, 2010·Reviews on Recent Clinical Trials·I BeliV Kouloulias
Jul 7, 2010·The British Journal of Radiology·J F Fowler
Nov 20, 2012·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Søren M BentzenGordon Whitmore
Mar 15, 2013·The New England Journal of Medicine·Sarah C DarbyPer Hall
Jun 14, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Johannes A LangendijkMarcel Verheij
Sep 14, 2013·Physics in Medicine and Biology·Aswin L Hoffmann, Alan E Nahum
Aug 31, 2014·European Urology·Bridget F KoontzAnthony D'Amico
Dec 17, 2014·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Wei-Xiang QiXiao-Mao Guo
Mar 24, 2015·Clinical Oncology : a Journal of the Royal College of Radiologists·Alan E Nahum
Sep 20, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Pierre BlanchardSteven J Frank

❮ Previous
Next ❯

Citations

Jan 15, 2019·Physics in Medicine and Biology·S C M Ten EikelderZ Perkó
Jan 4, 2018·International Journal of Radiation Biology·Irina RaznitsynaAlexey Glazkov

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.