(Radio)Biological Optimization of External-Beam Radiotherapy
Open Access
- 6 November 2012
- journal article
- research article
- Published by Hindawi Limited in Computational and Mathematical Methods in Medicine
- Vol. 2012, 1-13
- https://doi.org/10.1155/2012/329214
Abstract
“Biological optimization” (BIOP) means planning treatments using (radio)biological criteria and models, that is, tumour control probability and normal-tissue complication probability. Four different levels of BIOP are identified: Level I is “isotoxic” individualization of prescription dose at fixed fraction number. is varied to keep the NTCP of the organ at risk constant. Significant improvements in local control are expected for non-small-cell lung tumours. Level II involves the determination of an individualized isotoxic combination of and fractionation scheme. This approach is appropriate for “parallel” OARs (lung, parotids). Examples are given using our BioSuite software. Hypofractionated SABR for early-stage NSCLC is effectively Level-II BIOP. Level-III BIOP uses radiobiological functions as part of the inverse planning of IMRT, for example, maximizing TCP whilst not exceeding a given NTCP. This results in non-uniform target doses. The NTCP model parameters (reflecting tissue “architecture”) drive the optimizer to emphasize different regions of the DVH, for example, penalising high doses for quasi-serial OARs such as rectum. Level-IV BIOP adds functional imaging information, for example, hypoxia or clonogen location, to Level III; examples are given of our prostate “dose painting” protocol, BioProp. The limitations of and uncertainties inherent in the radiobiological models are emphasized.Keywords
This publication has 72 references indexed in Scilit:
- Results of a Multicentric In Silico Clinical Trial (ROCOCO): Comparing Radiotherapy with Photons and Protons for Non-small Cell Lung CancerJournal of Thoracic Oncology, 2012
- Inclusion of clinical risk factors into NTCP modelling of late rectal toxicity after high dose radiotherapy for prostate cancerRadiotherapy and Oncology, 2011
- Molecular Imaging–Based Dose Painting: A Novel Paradigm for Radiation Therapy PrescriptionSeminars in Radiation Oncology, 2011
- The ESTRO Breur Lecture 2009. From population to voxel-based radiotherapy: Exploiting intra-tumour and intra-organ heterogeneity for advanced treatment of non-small cell lung cancerRadiotherapy and Oncology, 2010
- Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): An Introduction to the Scientific IssuesInternational Journal of Radiation Oncology*Biology*Physics, 2010
- The Lessons of QUANTEC: Recommendations for Reporting and Gathering Data on Dose–Volume Dependencies of Treatment OutcomeInternational Journal of Radiation Oncology*Biology*Physics, 2010
- Radiation Dose–Volume Effects in the LungInternational Journal of Radiation Oncology*Biology*Physics, 2010
- To Bleed or Not to Bleed. A Prediction Based on Individual Gene Profiling Combined With Dose–Volume Histogram Shapes in Prostate Cancer Patients Undergoing Three-Dimensional Conformal Radiation TherapyInternational Journal of Radiation Oncology*Biology*Physics, 2009
- Analysis of Radiation Pneumonitis Risk Using a Generalized Lyman ModelInternational Journal of Radiation Oncology*Biology*Physics, 2008
- Reporting and analyzing dose distributions: A concept of equivalent uniform doseMedical Physics, 1997