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Titolo: Stochastic optimization of intensity modulated radiotherapy to account foruncertainties in patient sensitivity
Autore: Kaver, G; Lind, BK; Lof, J; Liander, A; Brahme, A;
 Indirizzi:
 Karolinska Inst, Dept Med Radiat Phys, S17176 Stockholm, Sweden Karolinska Inst Stockholm Sweden S17176 Phys, S17176 Stockholm, Sweden Stockholm Univ, S17176 Stockholm, Sweden Stockholm Univ Stockholm Sweden S17176 Univ, S17176 Stockholm, Sweden
 Titolo Testata:
 PHYSICS IN MEDICINE AND BIOLOGY
fascicolo: 12,
volume: 44,
anno: 1999,
pagine: 2955  2969
 SICI:
 00319155(199912)44:12<2955:SOOIMR>2.0.ZU;26
 Fonte:
 ISI
 Lingua:
 ENG
 Soggetto:
 RADIATION BEAM PROFILES; RADIOSENSITIVITY; PROBABILITY; THERAPY; TUMOR; HEAD;
 Tipo documento:
 Article
 Natura:
 Periodico
 Settore Disciplinare:
 Life Sciences
 Citazioni:
 21
 Recensione:
 Indirizzi per estratti:
 Indirizzo: Kaver, G Karolinska Inst, Dept Med Radiat Phys, POB 260, S17176 Stockholm, Sweden Karolinska Inst POB 260 Stockholm Sweden S17176 ockholm, Sweden



 Citazione:
 G. Kaver et al., "Stochastic optimization of intensity modulated radiotherapy to account foruncertainties in patient sensitivity", PHYS MED BI, 44(12), 1999, pp. 29552969
Abstract
The aim of the present work is to better account for the known uncertainties in radiobiological response parameters when optimizing radiation therapy. The radiation sensitivity of a specific patient is usually unknown beyondthe expectation value and possibly the standard deviation that may be derived from studies on groups of patients. Instead of trying to find the treatment with the highest possible probability of a desirable outcome for a patient of average sensitivity, it is more desirable to maximize the expectation value of the probability for the desirable outcome over the possible range of variation of the radiation sensitivity of the patient. Such a stochastic optimization will also have to consider the distribution function of the radiation sensitivity and the larger steepness of the response for the individual patient. The results of stochastic optimization are also compared with simpler methods such as using biological response 'margins' to accountfor the range of sensitivity variation. By using stochastic optimization, the absolute gain will typically be of the order of a few per cent and the relative improvement compared with nonstochastic optimization is generallyless than about 10 per cent. The extent of this gain varies with the levelof interpatient variability as well as with the difficulty and complexity of the case studied. Although the dose changes are rather small (<5 Gy) there is a strong desire to make treatment plans more robust, and tolerant of the likely range of variation of the radiation sensitivity of each individual patient. When more accurate predictive assays of the radiation sensitivity for each patient become available, the need to consider the range of variations can be reduced considerably.
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Documento generato il 02/12/20 alle ore 14:51:12