Loss of radiobiological effect of imaging dose in image guided radiotherapy due to prolonged imaging-to-treatment times

Medical Physics
Ryan T Flynn

Abstract

Increased use of cone beam CT guidance in image guided radiotherapy has prompted the inclusion of the imaging dose in treatment plans, thus using imaging beams to treat tumors. Sublethal radiation damage repair during tau(d), the time between imaging and treatment, could reduce the effectiveness of the imaging dose, resulting in tumor underdosage. The theoretical magnitude of this effect was quantified using radiobiological modeling. The therapeutic effective dose (TED), which, if delivered using only therapeutic beams, would result in the same tumor cell survival as for both the imaging and therapeutic beams, was derived using the generalized linear-quadratic model. The correction factor P(d) by which therapeutic dose can be scaled to compensate for sublethal damage repair was also derived. TED and P(d) are dependent on alpha/beta, sublethal damage repair half-time (T(r)), imaging dose (D(I)) and dose rate (D(I)), therapeutic dose (D(T)) and dose rate (D(T)), and tau(d). TED and P(d) were calculated as a function of tau(d), and each parameter was varied independently while holding the remaining parameters at their reference values. The reference values were based on prostate cancer cells and were D(p) = D(I)+D(T) = 1.8 Gy, D(I...Continue Reading

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Citations

Feb 20, 2016·Journal of Applied Clinical Medical Physics·Jean-Pierre MegeDimitri Lefkopoulos

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