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Titolo:
Optimization of the dose level for a given treatment plan to maximize the complication-free tumor cure
Autore:
Lind, BK; Mavroidis, P; Hyodynmaa, S; Kappas, C;
Indirizzi:
Karolinska Inst, Dept Med Radiat Phys, Stockholm, Sweden Karolinska Inst Stockholm Sweden ept Med Radiat Phys, Stockholm, Sweden Stockholm Univ, S-10691 Stockholm, Sweden Stockholm Univ Stockholm Sweden S-10691 Univ, S-10691 Stockholm, Sweden Tampere Univ Hosp, Dept Radiat Therapy, Tampere, Finland Tampere Univ Hosp Tampere Finland Dept Radiat Therapy, Tampere, Finland Univ Patras, Sch Med, Dept Med Phys, GR-26110 Patras, Greece Univ Patras Patras Greece GR-26110 ept Med Phys, GR-26110 Patras, Greece
Titolo Testata:
ACTA ONCOLOGICA
fascicolo: 6, volume: 38, anno: 1999,
pagine: 787 - 798
SICI:
0284-186X(1999)38:6<787:OOTDLF>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
RADIATION BEAM PROFILES; NORMAL TISSUE; THERAPY; DISTRIBUTIONS; PROBABILITY; RADIOTHERAPY; VOLUME; MODEL; IRRADIATION; STATISTICS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Lind, BK Karolinska Inst, Dept Med Radiat Phys, Stockholm, Sweden Karolinska Inst Stockholm Sweden adiat Phys, Stockholm, Sweden
Citazione:
B.K. Lind et al., "Optimization of the dose level for a given treatment plan to maximize the complication-free tumor cure", ACTA ONCOL, 38(6), 1999, pp. 787-798

Abstract

During the past decade, tumor and normal tissue reactions after radiotherapy have been increasingly quantified in radiobiological terms. For this purpose, response models describing the dependence of tumor and normal tissue reactions on the irradiated volume: heterogeneity of the delivered dose distribution and cell sensitivity variations can be taken into account. The probability of achieving a good treatment outcome can be increased by using an objective function such as P-divided by, the probability of complication-free tumor control. A new procedure is presented, which quantifies P-divided by from the dose delivery on 2D surfaces and 3D volumes and helps the user of any treatment planning system (TPS) to select the best beam orientations, the best beam modalities and the most suitable beam energies. The finalstep of selecting the prescribed dose level is made by a renormalization of the entire dose plan until the value of P-divided by is maximized. The index P-divided by makes use of clinically established dose-response parameters, for tumors and normal tissues of interest, in order to improve its clinical relevance. The results, using P-divided by, are compared against the assessments of experienced medical physicists and radiation oncologists for two clinical cases. It is observed that when the absorbed dose level for a given treatment plan is increased, the treatment outcome first improves rapidly. As the dose approaches the tolerance of normal tissues the complication-free cure begins to drop. The optimal dose level is often just below this point and it depends on the geometry of each patient and target volume. Furthermore, a more conformal dose delivery to the target results in a higher control rate for the same complication level. This effect can be quantified by the increased value of the P-divided by parameter.

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Documento generato il 02/12/20 alle ore 15:33:12