3D calculation of radiation‐induced second cancer risk including dose and tissue response heterogeneities

Abstract

The results demonstrate that relative MIP is a useful metric with which treatment plans can be ranked, regardless of parameter- and model-based uncertainties. With further validation, this metric could be used to discriminate between plans that are equivalent with respect to other planning priorities.

Dynamic collimator trajectory algorithm for multiple metastases dynamic conformal arc treatment planning

“…Although certainly secondary considerations, long beam-on times also raise questions about leakage dose, with implications for both radiation safety (e.g., bunker wall thickness) 12 and secondary malignancies in patients. [13][14][15] With respect to the comparable normal tissue dose (point 2), our data indicate that conformal plans had normal tissue values comparable to that of the highly modulated VMAT plans. Even in cases with four targets all within 1 cm of an OAR, the optimized DCA treatments did not significantly deviate from VMAT OAR doses.…”

“…When put in the context of SRS or SBRT treatments (i.e., high dose, high‐dose gradient treatments), significant reductions of beam‐on time confer the advantage of reducing the time available for intrafraction motion. Although certainly secondary considerations, long beam‐on times also raise questions about leakage dose, with implications for both radiation safety (e.g., bunker wall thickness) and secondary malignancies in patients …”

Intra‐arc binary collimation algorithm for the optimization of stereotactic radiotherapy treatment of multiple metastases with multiple prescriptions

“…The data demonstrate that iABC is more effective at reducing the low dose wash relative to VMAT, on average. While this dose range is below the dose level correlated with brain necrosis, 16 it suggests a systematic sparing in ranges which have become of increasing concern with regard to secondary malignancies 17 and may be of increased importance for retreatments. Figure 9 further illustrates the benefits of iABC to conformal treatments as the volume receiving the lowest prescription dose decreases with implementation of iABC when compared to optimized DCA, although this also did not reach statistical significance.…”

Age at exposure and attained age variations of cancer risk in the Japanese A‐bomb and radiotherapy cohorts

“…Various theoretical models for radiation-induced cancer have been developed with model parameters fitted to clinical data. [1][2][3][4][5][6][7][8][9][10][11][12] Recent studies [16][17][18][19] have applied the S-model 8,10 to estimate the outcome of different treatment modalities with regard to radiation-induced cancer. Based on assumptions on cell repopulation/repair, mutation, and sterilization, the S-model gives a dose dependent formulation for the excess absolute risk (EAR).…”

“…Phenomenological risk models are frequently applied to estimate the risk of radiation-induced cancers at radiotherapy doses. [1][2][3][4][5][6][7][8][9][10][11][12] From the analysis of the Hiroshima and Nagasaki atomicbomb (A-bomb) survivors, it is known that solid cancer risk per unit dose varies significantly with both age at exposure and attained age. 13,14 Any realistic model of radiation-induced cancer at radiotherapy doses should therefore include the age dependence of risk.…”