Dosimetric Precision Requirements in Radiation Therapy

Brahme, Anders

doi:10.3109/02841868409136037

Cited by 460 publications

(244 citation statements)

References 29 publications

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“…The parameter g 50 is defined as the absolute percentage increment in response rate per 1% increase in total dose at the 50% response level (45). For normal tissues, typical values for g 50 lie between 2 and 4, so a 2.0-Gy increment in total dose above 50 Gy in 25 fractions to the breast, representing a 4% increase in total dose, causes an 8% to 16% absolute increase in the probability of an adverse effect around the 50% response level (46).…”

Section: Dose Escalation Has a Much Greater Effect On Normal Tissue Rmentioning

confidence: 99%

Hypofractionated Whole-Breast Radiotherapy for Women With Early Breast Cancer: Myths and Realities

Yarnold

Bentzen

Coles

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

148

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Section: Dose Escalation Has a Much Greater Effect On Normal Tissue Rmentioning

confidence: 99%

Hypofractionated Whole-Breast Radiotherapy for Women With Early Breast Cancer: Myths and Realities

Yarnold

Bentzen

Coles

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

148

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“…Others have recommended to report the mean target dose and its variance, based on the finding that, for small variances, the mean dose often correlates well with outcome [4]. The use of quadratic dose objectives in IMRT optimization is in line with this approach.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Target Cold Spots By the use of Tail EUDs

Bortfeld

Craft

Dempsey

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To propose a new measure of target underdose that can be used in the evaluation and optimization of radiotherapy dose distributions.Methods and Materials-We compare various formulations of the equivalent uniform dose (EUD) and introduce a modification of existing EUD definitions, which we call tail EUD. Tail EUD is a measure of "cold spots" below the prescription dose in the target dose distribution. It has units of Gy. We investigate the mathematical properties of various target EUD concepts, including tail EUD. We apply the tail EUD measure retrospectively to intensity modulated radiation therapy (IMRT) treatment plans from our plan database. We also use tail EUD as an optimization objective in the optimization of prostate, pancreas, and head&neck plans.Results-Tail EUD has desirable mathematical properties. In particular, it is convex and it leads to convex level sets (i.e., no local minima) if the EUD from which it is derived is concave. The tail EUD value is correlated with the subjective degree of target coverage. Constraining tail EUDs to a certain level in plan optimization leads to comparable target coverage in different plans and treatment sites.Conclusions-The newly introduced concept of tail EUD appears to be useful both for plan evaluation and optimization. In addition, it can potentially be applied in the design of new clinical protocols.

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“…However, it should be pointed out that the relative steepness is then significantly lower than if a fractionation schedule with a fixed number of dose fractions is used (cf. 2,8). Older studies that often employed the NSD or CRE formalism automatically yielded such steep dose-response relationships.…”

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confidence: 99%