Radiobiologically guided optimisation of the prescription dose and fractionation scheme in radiotherapy using BioSuite

Uzan, J.; Nahum, Alan E.

doi:10.1259/bjr/20476567

Cited by 61 publications

(55 citation statements)

References 43 publications

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“…Normal tissue control probability (NTCP) was calculated using the BioSuite software, designed for radiobiological analysis (11). A LymanKutcher-Burman model was used to determine the probability of lung radiation pneumonitis (TD 50 =29.2 Gy, m=0.45, n=1, α/β=3 Gy) (12) and acute esophageal toxicity grade ≥2 (TD 50 =47 Gy, m=0.36, n=0.69, α/β=1.7 Gy) (13).…”

Section: Discussionmentioning

confidence: 99%

Limiting the risk of cardiac toxicity with esophageal-sparing intensity modulated radiotherapy for locally advanced lung cancers

et al. 2016

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Background: Intensity modulated radiotherapy (IMRT) is routinely utilized in the treatment of locally advanced non-small cell lung cancer (NSCLC). RTOG 0617 found that overall survival was impacted by increased low (5 Gy) and intermediate (30 Gy) cardiac doses. We evaluated the impact of esophageal-sparing IMRT on cardiac doses with and without the heart considered in the planning process and predicted toxicity compared to 3D-conventional radiotherapy (3DCRT). Methods: Ten consecutive patients with N2 Stage III NSCLC treated to 60 Gy in 30 fractions, betweenFebruary 2012 and September 2014, were evaluated. For each patient, 3DCRT and esophageal-sparing IMRT plans were generated. IMRT plans were then created with and without the heart considered in the optimization process. To compare plans, the dose delivered to 95% and 99% of the target (D 95% and D 99% ), and doses to the esophagus, lung and heart were compared by determining the volume receiving X dose (V XGy ) and the normal tissue complication probability (NTCP) calculated. Results: IMRT reduced maximum esophagus dose to below 60 Gy in all patients and produced significant reductions to V 50Gy , V 40Gy and esophageal NTCP. The cost of this reduction was a non-statistically, nonclinically significant increase in low dose (5 Gy) lung exposure that did not worsen lung NTCP. IMRT plans produced significant cardiac sparing, with the amount of improvement correlating to the amount of heart overlapping with the target. When included in plan optimization, for selected patients further sparing of the heart and improvement in heart NTCP was possible. Conclusions: Esophageal-sparing IMRT can significantly spare the heart even if it is not considered in the optimization process. Further sparing can be achieved if plan optimization constrains low and intermediate heart doses, without compromising lung doses.

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Section: Discussionmentioning

confidence: 99%

Limiting the risk of cardiac toxicity with esophageal-sparing intensity modulated radiotherapy for locally advanced lung cancers

et al. 2016

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“…For this reason, comparisons were also made by considering radiobiological indexes for both PTV and OAR, namely tumor control probability (TCP) and normal tissue complication probability (NTCP). These parameters were calculated by employing BioSuite, (20) a software tool specifically designed for radiobiological analysis. TCP values were obtained by using a Poisson model, (21) while NTCP parameters were obtained by using a Lyman‐Kutcher‐Burman (LKB) model 22 , 23 .…”

Section: Methodsmentioning

confidence: 99%

“…Since there is much discussion on the appropriate parameters to be used in order to model tumor control for prostate cases, 24 , 25 , 26 , 27 , 28 different combinations of modeling values were used in this analysis. As previously performed by Uzan and Nahum, (20) the

α / β

ratio was varied between 5 and 1.5 Gy. Despite the general belief that the

α / β

ratio should be low for these types of tumors, the value of 5 Gy was also considered, since several authors have highlighted the possible effect of hypoxia or dose heterogeneity in the assessment of

α / β

for prostate cancer 25 , 28 …”

Section: Methodsmentioning

confidence: 99%

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Comparison of IPSA and HIPO inverse planning optimization algorithms for prostate HDR brachytherapy

Panettieri

Smith

Mason

et al. 2014

J Applied Clin Med Phys

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Publications have reported the benefits of using high‐dose‐rate brachytherapy (HDRB) for the treatment of prostate cancer, since it provides similar biochemical control as other treatments while showing lowest long‐term complications to the organs at risk (OAR). With the inclusion of anatomy‐based inverse planning optimizers, HDRB has the advantage of potentially allowing dose escalation. Among the algorithms used, the Inverse Planning Simulated Annealing (IPSA) optimizer is widely employed since it provides adequate dose coverage, minimizing dose to the OAR, but it is known to generate large dwell times in particular positions of the catheter. As an alternative, the Hybrid Inverse treatment Planning Optimization (HIPO) algorithm was recently implemented in Oncentra Brachytherapy V. 4.3. The aim of this work was to compare, with the aid of radiobiological models, plans obtained with IPSA and HIPO to assess their use in our clinical practice. Thirty patients were calculated with IPSA and HIPO to achieve our department's clinical constraints. To evaluate their performance, dosimetric data were collected: Prostate PTV D90(%),V100(%),V150(%), and V200(%), Urethra D10(%), Rectum D2cc(%), and conformity indices. Additionally tumor control probability (TCP) and normal tissue complication probability (NTCP) were calculated with the BioSuite software. The HIPO optimization was performed firstly with Prostate PTV (HIPOPTV) and then with Urethra as priority 1 (HIPOurethra). Initial optimization constraints were then modified to see the effects on dosimetric parameters, TCPs, and NTCPs. HIPO optimizations could reduce TCPs up to 10%–20% for all PTVs lower than 74 cm3. For the urethra, IPSA and HIPOurethra provided similar NTCPs for the majority of volume sizes, whereas HIPOPTV resulted in large NTCP values. These findings were in agreement with dosimetric values. By increasing the PTV maximum dose constraints for HIPOurethra plans, TCPs were found to be in agreement with IPSA without affecting the urethral NTCPs.PACS numbers: 87.55.‐x, 87.55.de, 87.55.dh, 87.53.Jw

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“…Ex. There is equivalence between LQ S(d, α=0.307 Gy -1 , α/β=10 Gy) of [2] and SMp K(d, dminK=0.2 Gy, dmaxK=8 Gy, pK=0.4).…”

Section: The Smp K(d)mentioning

confidence: 98%

The Statistical Models Project (SMp) for Evaluations of Biological Radiation Effects

Frometa-Castillo¹

2017

AJAMS

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This document provides probabilistic-mechanistic models for describing the cell kill (K) and cell sublethal damage (SL) for one fraction with a dose of radiation that is absorbed by a living tissue; also this provides the K and SL formalisms for fractioned irradiation regimens. These models and formalisms are based on real mean behavior of cell survival (S) -a complement of K-and strong probabilistic-radiobiological foundations. The K and SL formalisms include all possible factors affecting the biological radiation effects: dose (d), fractionations (n), SL, and the temporal factors: cell repair and cell repopulation. It is discussed some aspects about the widely used linearquadratic (LQ) S(d) model and LQ S(n,d) formalism, and one of its derivations, the BED (biologically effective dose). The SMp K(d) parameters can be obtained from S data, or using graphical/analytical tools developed by this study. These new formalisms will be useful for simulations of treatments, and together regional damage distribution for optimizations of the treatment planning. Keywords: BED, LQ model, stochastic effects, cell survivalCite This Article: Terman Frometa-Castillo, "The Statistical Models Project (SMp) for Evaluations of Biological Radiation Effects

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Radiobiologically guided optimisation of the prescription dose and fractionation scheme in radiotherapy using BioSuite

Cited by 61 publications

References 43 publications

Limiting the risk of cardiac toxicity with esophageal-sparing intensity modulated radiotherapy for locally advanced lung cancers

Limiting the risk of cardiac toxicity with esophageal-sparing intensity modulated radiotherapy for locally advanced lung cancers

Comparison of IPSA and HIPO inverse planning optimization algorithms for prostate HDR brachytherapy

The Statistical Models Project (SMp) for Evaluations of Biological Radiation Effects

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